Provider Demographics
NPI:1346895950
Name:EB CARE AT ENGLEWOOD, LLC
Entity Type:Organization
Organization Name:EB CARE AT ENGLEWOOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-474-1200
Mailing Address - Street 1:412 SOUTH VAN BRUNT STREET
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:551-775-6100
Mailing Address - Fax:551-775-6124
Practice Address - Street 1:412 SOUTH VAN BRUNT STREET
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:551-775-6100
Practice Address - Fax:551-775-6124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility