Provider Demographics
NPI:1225492705
Name:2020 ROUTE 23 OPERATING COMPANY LLC
Entity Type:Organization
Organization Name:2020 ROUTE 23 OPERATING COMPANY LLC
Other - Org Name:ATRIUM POST ACUTE CARE OF WAYNE VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-953-0546
Mailing Address - Street 1:2020 ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6521
Mailing Address - Country:US
Mailing Address - Phone:973-305-8400
Mailing Address - Fax:
Practice Address - Street 1:2020 ROUTE 23
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6521
Practice Address - Country:US
Practice Address - Phone:973-305-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061629314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ512346Medicaid
NJ0512346Medicaid