Provider Demographics
NPI:1104823764
Name:REGENT CARE CENTER, INC.
Entity Type:Organization
Organization Name:REGENT CARE CENTER, INC.
Other - Org Name:REGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PINELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-489-7400
Mailing Address - Street 1:50 POLIFLY RD
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3287
Mailing Address - Country:US
Mailing Address - Phone:201-646-1166
Mailing Address - Fax:201-487-3835
Practice Address - Street 1:50 POLIFLY RD
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3287
Practice Address - Country:US
Practice Address - Phone:201-646-1166
Practice Address - Fax:201-487-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060231314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ02830OtherNJ
NJ4465504Medicaid
315295Medicare Oscar/Certification