Provider Demographics
NPI:1497312706
Name:LEBANON CENTER FOR REHABILITATION AND HEALING LLC
Entity Type:Organization
Organization Name:LEBANON CENTER FOR REHABILITATION AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-731-1700
Mailing Address - Street 1:731 CASTLE HEIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2646
Mailing Address - Country:US
Mailing Address - Phone:615-444-4319
Mailing Address - Fax:615-444-4393
Practice Address - Street 1:731 CASTLE HEIGHTS CT
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2646
Practice Address - Country:US
Practice Address - Phone:615-444-4319
Practice Address - Fax:615-444-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility