Provider Demographics
NPI:1407412547
Name:ABBEY WOODS OPERATIONS LLC
Entity Type:Organization
Organization Name:ABBEY WOODS OPERATIONS LLC
Other - Org Name:POLARIS HEALTH & WELLNESS OF ABBEY WOODS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-727-1634
Mailing Address - Street 1:1776 AVENUE OF THE STATES STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4592
Mailing Address - Country:US
Mailing Address - Phone:516-727-1634
Mailing Address - Fax:
Practice Address - Street 1:5026 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3375
Practice Address - Country:US
Practice Address - Phone:816-279-1591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility