Provider Demographics
NPI:1083620371
Name:WHITE HORSE HEALTH CARE, LLC
Entity Type:Organization
Organization Name:WHITE HORSE HEALTH CARE, LLC
Other - Org Name:INNOVA HEALTH AND REHAB AT HAMMONTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-835-5555
Mailing Address - Street 1:43 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1875
Mailing Address - Country:US
Mailing Address - Phone:609-567-3100
Mailing Address - Fax:609-567-0615
Practice Address - Street 1:43 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1875
Practice Address - Country:US
Practice Address - Phone:609-567-3100
Practice Address - Fax:609-567-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060113314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4463005Medicaid
NJ4463005Medicaid