Provider Demographics
NPI:1497872956
Name:CEDAR OAKS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:CEDAR OAKS HEALTHCARE, LLC
Other - Org Name:ARISTACARE AT CEDAR OAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HESHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-315-3400
Mailing Address - Street 1:1311 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2309
Mailing Address - Country:US
Mailing Address - Phone:732-287-9555
Mailing Address - Fax:732-287-1226
Practice Address - Street 1:1311 DURHAM AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2309
Practice Address - Country:US
Practice Address - Phone:732-287-9555
Practice Address - Fax:732-287-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061216314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4485106Medicaid
NJ315214Medicare ID - Type Unspecified