Provider Demographics
NPI:1811994890
Name:ATLANTIC COAST REHAB & CARE CENTER LLC
Entity type:Organization
Organization Name:ATLANTIC COAST REHAB & CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIEROVITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-7100
Mailing Address - Street 1:485 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:485 RIVER AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4720
Practice Address - Country:US
Practice Address - Phone:732-364-7100
Practice Address - Fax:732-364-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061504314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4495306Medicaid
NJA406796OtherOXFORD INSURANCE
NJA406796OtherOXFORD INSURANCE
NJ4495306Medicaid
315115Medicare Oscar/Certification