Provider Demographics
NPI:1104850791
Name:MEGA CARE INC.
Entity Type:Organization
Organization Name:MEGA CARE INC.
Other - Org Name:GREENBROOK MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-851-8355
Mailing Address - Street 1:54 NEWCOMBE ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1236
Mailing Address - Country:US
Mailing Address - Phone:973-450-2908
Mailing Address - Fax:973-844-4705
Practice Address - Street 1:303 ROCK AVE
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-2616
Practice Address - Country:US
Practice Address - Phone:732-424-5225
Practice Address - Fax:732-968-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061805314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4499603Medicaid
NJ315141Medicare Oscar/Certification