Provider Demographics
NPI:1952589152
Name:METROPOLITAN HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:METROPOLITAN HEALTH CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:INN
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CSW
Authorized Official - Phone:201-243-0666
Mailing Address - Street 1:300 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3518
Mailing Address - Country:US
Mailing Address - Phone:201-243-0666
Mailing Address - Fax:201-243-0016
Practice Address - Street 1:300 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3518
Practice Address - Country:US
Practice Address - Phone:201-243-0666
Practice Address - Fax:201-243-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ408210311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0020788Medicaid