Provider Demographics
NPI:1881828705
Name:CLIVEDEN CENTER, LLC
Entity Type:Organization
Organization Name:CLIVEDEN CENTER, LLC
Other - Org Name:ARISTACARE AT CLIVEDEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HESHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-315-3410
Mailing Address - Street 1:51 CRAGWOOD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2405
Mailing Address - Country:US
Mailing Address - Phone:908-315-3410
Mailing Address - Fax:908-292-1020
Practice Address - Street 1:6400 GREENE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3231
Practice Address - Country:US
Practice Address - Phone:215-844-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA330402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility