Provider Demographics
NPI:1073688222
Name:PRINCETON NURSING HOME &REHABILITATION CENTER INC.
Entity Type:Organization
Organization Name:PRINCETON NURSING HOME &REHABILITATION CENTER INC.
Other - Org Name:PRINCETON CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FIRST
Authorized Official - Suffix:
Authorized Official - Credentials:LNMA
Authorized Official - Phone:609-924-9000
Mailing Address - Street 1:728 BUNN DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1963
Mailing Address - Country:US
Mailing Address - Phone:609-924-9000
Mailing Address - Fax:609-921-2451
Practice Address - Street 1:728 BUNN DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1963
Practice Address - Country:US
Practice Address - Phone:609-924-9000
Practice Address - Fax:609-921-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061107314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4483103Medicaid
NJ4483103Medicaid