Provider Demographics
NPI:1861629156
Name:CLARA MAASS MEDICAL CENTER
Entity Type:Organization
Organization Name:CLARA MAASS MEDICAL CENTER
Other - Org Name:CLARA MAASS MEDICAL CENTER TRANSITIONAL CARE UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CLYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-450-2002
Mailing Address - Street 1:1 CLARA MAASS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3550
Mailing Address - Country:US
Mailing Address - Phone:973-450-2000
Mailing Address - Fax:973-844-4908
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2008
Practice Address - Fax:973-844-4908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARNABAS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-15
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10701314000000X
NJ314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4135504Medicaid
315505Medicare Oscar/Certification