Provider Demographics
NPI:1033106968
Name:SAINT CLARE'S HOSPITAL INC.
Entity Type:Organization
Organization Name:SAINT CLARE'S HOSPITAL INC.
Other - Org Name:THE DWELLING PLACE AT SAINT CLARE'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:973-989-3539
Mailing Address - Street 1:400 W BLACKWELL ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-2525
Mailing Address - Country:US
Mailing Address - Phone:973-989-3539
Mailing Address - Fax:
Practice Address - Street 1:400 W BLACKWELL ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-2525
Practice Address - Country:US
Practice Address - Phone:973-989-3539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ11420L314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14278Medicaid
NJ1427VMedicaid
315019Medicare ID - Type UnspecifiedMEDICARE PROIDER NUMBER