Provider Demographics
NPI:1811970940
Name:HARROGATE INCORPORATED
Entity type:Organization
Organization Name:HARROGATE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/TRUSTEE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-905-7070
Mailing Address - Street 1:400 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7408
Mailing Address - Country:US
Mailing Address - Phone:732-905-7070
Mailing Address - Fax:732-905-2824
Practice Address - Street 1:400 LOCUST ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7408
Practice Address - Country:US
Practice Address - Phone:732-905-7070
Practice Address - Fax:732-905-2824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061528314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315262Medicare ID - Type UnspecifiedPROVIDER NUMBER
315262Medicare Oscar/Certification