Provider Demographics
NPI:1083206437
Name:SUSQUEHANNA REHABILITATION & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:SUSQUEHANNA REHABILITATION & WELLNESS CENTER LLC
Other - Org Name:SUSQUEHANNA HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-994-7502
Mailing Address - Street 1:745 OLD CHIQUES HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17512-8401
Mailing Address - Country:US
Mailing Address - Phone:717-684-7555
Mailing Address - Fax:717-684-3677
Practice Address - Street 1:745 OLD CHIQUES HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17512-8401
Practice Address - Country:US
Practice Address - Phone:717-684-7555
Practice Address - Fax:717-684-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility