Provider Demographics
NPI:1487641767
Name:LLMD ASSOCIATES LLC
Entity Type:Organization
Organization Name:LLMD ASSOCIATES LLC
Other - Org Name:WATERSEDGE HEALTHCARE & REHABILATAION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LIZER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOZEFOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:609-393-8622
Mailing Address - Street 1:512 UNION ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-2800
Mailing Address - Country:US
Mailing Address - Phone:609-393-8622
Mailing Address - Fax:609-393-9655
Practice Address - Street 1:512 UNION ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-2800
Practice Address - Country:US
Practice Address - Phone:609-393-8622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5561400Medicaid
NJ5561400Medicaid