Provider Demographics
NPI:1578550828
Name:EMERSON CONVALESCENT CENTER INC
Entity Type:Organization
Organization Name:EMERSON CONVALESCENT CENTER INC
Other - Org Name:EMERSON HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:201-265-3700
Mailing Address - Street 1:100 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1828
Mailing Address - Country:US
Mailing Address - Phone:201-265-3700
Mailing Address - Fax:201-967-5219
Practice Address - Street 1:100 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1828
Practice Address - Country:US
Practice Address - Phone:201-265-3700
Practice Address - Fax:201-967-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060202314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4464206Medicaid
NJ4464206Medicaid