Provider Demographics
NPI:1376063651
Name:LAUREL BROOK OPERATOR LLC
Entity Type:Organization
Organization Name:LAUREL BROOK OPERATOR LLC
Other - Org Name:LAUREL BROOK REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICARE ADMINISTRATION OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MINDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:732-903-1958
Mailing Address - Street 1:635 DUQUESNE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-5073
Mailing Address - Country:US
Mailing Address - Phone:732-903-1958
Mailing Address - Fax:
Practice Address - Street 1:3718 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1104
Practice Address - Country:US
Practice Address - Phone:856-235-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility