Provider Demographics
NPI:1235470022
Name:SUMMER HILL NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:SUMMER HILL NURSING & REHABILITATION CENTER LLC
Other - Org Name:SUMMER HILL NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-567-0400
Mailing Address - Street 1:170 53RD ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2630
Mailing Address - Country:US
Mailing Address - Phone:718-567-0400
Mailing Address - Fax:
Practice Address - Street 1:111 ROUTE 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1421
Practice Address - Country:US
Practice Address - Phone:732-254-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061210314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ448450990Medicaid
NJ315381Medicare Oscar/Certification