Provider Demographics
NPI:1932594033
Name:100 CHAPIN INC.
Entity Type:Organization
Organization Name:100 CHAPIN INC.
Other - Org Name:MAJESTIC REHABILITATION AND NURSING CENTER AT RED BANK INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-AVIV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-987-7180
Mailing Address - Street 1:4601 SHERIDAN ST
Mailing Address - Street 2:SUITE #600
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3440
Mailing Address - Country:US
Mailing Address - Phone:954-987-7180
Mailing Address - Fax:
Practice Address - Street 1:100 CHAPIN AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1418
Practice Address - Country:US
Practice Address - Phone:732-741-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061325314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ061325OtherSTATE LICENSE
NJ061325OtherSTATE LICENSE