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2ND HOME ELIZABETH LLC NPI 1336283027


NPI Information

NPI: 1336283027
Provider Name: 2ND HOME ELIZABETH LLC
Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
432 N BROAD ST
ELIZABETH, NJ
ZIP 07208
Phone: (908) 436-0018
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2ND HOME ELIZABETH LLC is a nursing facility intermediate care facility in Elizabeth, NJ. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. 2ND HOME ELIZABETH LLC NPI is 1336283027. The provider is registered as an organization entity type.

The provider's business location address is:

432 N BROAD ST
ELIZABETH, NJ
ZIP 07208-365
Phone: (908) 436-0018
Fax: (973) 278-4773

The provider's authorized official is David Myers .
The authorized official title is Medical Director and has the following contact phone number (973) 278-7065.

The enumeration date for this NPI number is 2/16/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care Facility908111NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17667027MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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