Provider Demographics
NPI:1164139564
Name:PRESCOTT NURSING AND REHAB BHC OPERATIONS
Entity Type:Organization
Organization Name:PRESCOTT NURSING AND REHAB BHC OPERATIONS
Other - Org Name:SKILLED NURSING FACILITY
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-589-4982
Mailing Address - Street 1:701 CROSS ST # 132
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4029
Mailing Address - Country:US
Mailing Address - Phone:917-589-4982
Mailing Address - Fax:
Practice Address - Street 1:140 PRESCOTT ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1826
Practice Address - Country:US
Practice Address - Phone:917-589-4982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherMEDICARE