Provider Demographics
NPI:1376887612
Name:BRIARWOOD OPERATOR, LLC
Entity Type:Organization
Organization Name:BRIARWOOD OPERATOR, LLC
Other - Org Name:BRIARWOOD REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:NACHUM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-232-9217
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-0090
Mailing Address - Country:US
Mailing Address - Phone:732-606-5973
Mailing Address - Fax:732-608-2976
Practice Address - Street 1:150 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2914
Practice Address - Country:US
Practice Address - Phone:781-449-4040
Practice Address - Fax:781-449-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0784Medicaid
MA0784Medicaid