Provider Demographics
NPI:1235591918
Name:MAGGIE VALLEY OPERATIONS LLC
Entity Type:Organization
Organization Name:MAGGIE VALLEY OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINMETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-813-5000
Mailing Address - Street 1:410 MONMOUTH AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FISHER LOOP
Practice Address - Street 2:
Practice Address - City:MAGGIE VALLEY
Practice Address - State:NC
Practice Address - Zip Code:28751-5531
Practice Address - Country:US
Practice Address - Phone:828-926-4326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
345102OtherMEDICARE ID