Provider Demographics
NPI:1780191544
Name:WOODS EDGE REHAB AND NURSING LLC
Entity type:Organization
Organization Name:WOODS EDGE REHAB AND NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MENDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRECHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-484-8888
Mailing Address - Street 1:5308 13TH AVE STE 273
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3804
Mailing Address - Country:US
Mailing Address - Phone:718-484-8888
Mailing Address - Fax:
Practice Address - Street 1:1171 TOWNE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-2227
Practice Address - Country:US
Practice Address - Phone:513-242-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility