Provider Demographics
NPI:1952397309
Name:SENIORCARE OF HAMILTON LLC
Entity Type:Organization
Organization Name:SENIORCARE OF HAMILTON LLC
Other - Org Name:HAMILTON CONT. CARE CTR.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LNHA
Authorized Official - Prefix:
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-588-0091
Mailing Address - Street 1:1059 EDINBURG RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1229
Mailing Address - Country:US
Mailing Address - Phone:609-588-0091
Mailing Address - Fax:
Practice Address - Street 1:1059 EDINBURG RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-1229
Practice Address - Country:US
Practice Address - Phone:609-588-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061111314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5212497OtherAETNA (TRADITIONAL)
NJ01000356300OtherAMERICHOICE
NJ315223OtherHORIZON BC/BS (SKILLED)
NJ8398208Medicaid
NJ2499838OtherAETNA (HMO)
NJ001018OtherHORIZON BC/BS (SUBACUTE)
NJ97307OtherAMERICAID
NJ5212497OtherAETNA (TRADITIONAL)
NJ315223Medicare ID - Type Unspecified