Provider Demographics
NPI:1093180572
Name:CORAL HARBOR OPERATOR LLC
Entity Type:Organization
Organization Name:CORAL HARBOR OPERATOR LLC
Other - Org Name:CORAL HARBOR REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICARE ADMINISTRATION OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-903-1958
Mailing Address - Street 1:2050 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6124
Mailing Address - Country:US
Mailing Address - Phone:732-774-8300
Mailing Address - Fax:732-774-0908
Practice Address - Street 1:2050 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753-6124
Practice Address - Country:US
Practice Address - Phone:732-774-8300
Practice Address - Fax:732-276-9659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUINTO GUARDIAN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-09
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061317314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility