Provider Demographics
NPI:1851826291
Name:COMPLETE CARE AT PASSAIC LLC
Entity Type:Organization
Organization Name:COMPLETE CARE AT PASSAIC LLC
Other - Org Name:COMPLETE CARE AT FAIR LAWN EDGE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHALOM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-966-3091
Mailing Address - Street 1:1 TRUMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5661
Mailing Address - Country:US
Mailing Address - Phone:732-966-3091
Mailing Address - Fax:
Practice Address - Street 1:77 E 43RD ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1116
Practice Address - Country:US
Practice Address - Phone:973-754-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility