Provider Demographics
NPI:1760108633
Name:CHESTELM SNF OPERATIONS LLC
Entity Type:Organization
Organization Name:CHESTELM SNF OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PINCHOS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-783-3110
Mailing Address - Street 1:534 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:MOODUS
Mailing Address - State:CT
Mailing Address - Zip Code:06469-1101
Mailing Address - Country:US
Mailing Address - Phone:860-873-1455
Mailing Address - Fax:
Practice Address - Street 1:534 TOWN ST
Practice Address - Street 2:
Practice Address - City:MOODUS
Practice Address - State:CT
Practice Address - Zip Code:06469-1101
Practice Address - Country:US
Practice Address - Phone:860-873-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility