Provider Demographics
NPI:1619439312
Name:MATAWAN SNF AMOP, LLC
Entity Type:Organization
Organization Name:MATAWAN SNF AMOP, LLC
Other - Org Name:SPRING HILLS POST ACUTE MATAWAN (SNF)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-953-0546
Mailing Address - Street 1:26 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3418
Mailing Address - Country:US
Mailing Address - Phone:201-953-0546
Mailing Address - Fax:
Practice Address - Street 1:38 FRENEAU AVE
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3323
Practice Address - Country:US
Practice Address - Phone:732-765-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ514017Medicaid
NJ514012Medicaid