Provider Demographics
NPI:1588609671
Name:REGAL HEIGHTS HEALTHCARE & REHAB CENTER, LLC
Entity Type:Organization
Organization Name:REGAL HEIGHTS HEALTHCARE & REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-262-2255
Mailing Address - Street 1:260 CHAMBERSBRIDGE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-2809
Mailing Address - Country:US
Mailing Address - Phone:732-262-2255
Mailing Address - Fax:732-262-3332
Practice Address - Street 1:6525 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9582
Practice Address - Country:US
Practice Address - Phone:302-998-0181
Practice Address - Fax:302-998-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1079314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000039774Medicaid
085006Medicare ID - Type UnspecifiedMEDICARE