Provider Demographics
NPI:1083151179
Name:BETHANY CENTER FOR REHABILITATION AND HEALING LLC
Entity Type:Organization
Organization Name:BETHANY CENTER FOR REHABILITATION AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-731-1700
Mailing Address - Street 1:421 OCALA DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6387
Mailing Address - Country:US
Mailing Address - Phone:615-834-4214
Mailing Address - Fax:615-833-9407
Practice Address - Street 1:421 OCALA DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-6387
Practice Address - Country:US
Practice Address - Phone:615-834-4214
Practice Address - Fax:615-833-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
445159Medicare Oscar/Certification