475 JACK MARTIN BOULEVARD OPERATIONS LLC (NPI# 1023493236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023493236 |
| Entity Type | Organization |
| Organization Name | 475 JACK MARTIN BOULEVARD OPERATIONS LLC |
| Other Organization Name | LAURELTON VILLAGE CARE CENTER |
| Practice Address |
475 Jack Martin Blvd Brick NJ 08724-7732 |
| Practice Telephone | 7324586600 |
| Practice Fax Number | 7324586601 |
| Mailing Telephone | 7324586600 |
| Mailing Fax Number | 7324586601 |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2016-01-05 |
| Authorized Official Name | MICHAEL T BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684742 |
| Is Organization Subpart | Y |
| Parent Organization Name | GENESIS NJ HOLDINGS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NJ | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Laurelton Village Care Center | Doing Business As Name - Organization |
| Street Address |
475 JACK MARTIN BLVD |
| City | BRICK |
| State | NJ |
| Zip Code | 08724-7732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306864194 | Rosanne Vantuono | Physical Medicine & Rehabilitation | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2006-07-18 |
| 1639646979 | Snehlata Patel | Occupational Therapist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2018-10-24 |
| 1679061030 | Complete Care At Laurelton LLC | Skilled Nursing Facility | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2018-05-01 |
| 1366947285 | Daniel Dacosta | Occupational Therapist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2018-03-25 |
| 1619341146 | Theresa Marie Stanczewski | Speech-Language Pathologist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-11-20 |
| 1851786651 | Deborah Lynn Bernhardt | Speech-Language Pathologist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-03-30 |
| 1871987032 | Erika M Serrano | Occupational Therapist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-03-26 |
| 1356735567 | Eileen Boyce | Occupational Therapy Assistant | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-03-25 |
| 1306230578 | Jeffrey Gabriel | Physical Therapist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-03-25 |
| 1295129419 | Suzan Hameed | Occupational Therapist | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2015-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386498 | Mark Malak | Pharmacist | 668 New Jersey Ave # 70, Brick, NJ 08724 | 2020-11-08 |
| 1699381681 | Kimberly Granai | Nurse Practitioner | 1617 Nj-88, Brick Township, NJ 08724 | 2020-09-16 |
| 1407461346 | Marina N Samuel | Pharmacist | 1890 Rt 88, Brick, NJ 08724 | 2020-09-08 |
| 1255974440 | Diana Rachel Williamson | Pharmacy Technician | 1610 Rt. 88 West, Suite 103, Brick, NJ 08724 | 2019-10-21 |
| 1710536842 | Stephanie Ann Papa | Nurse Practitioner | 2125 Nj 88, Brick, NJ 08724 | 2019-09-11 |
| 1417504515 | Susan B Anthony | Physical Therapist | 676 Overlook Ct, Brick, NJ 08724 | 2019-08-22 |
| 1831688076 | Jennifer S Cashin | Social Worker | 1500 Nj-88, Brick, NJ 08724 | 2018-05-03 |
| 1528555315 | James Kish Pt | Physical Therapist | 602 Yellowbrick Rd, Brick, NJ 08724 | 2018-04-17 |
| 1396262200 | Michael Stephen Zito-govert | Nurse Practitioner | 1640 Route 88 West, Suite 203, Brick, NJ 08724 | 2017-08-23 |
| 1083140420 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Route 70 East, Brick, NJ 08724 | 2017-05-04 |
| Find all providers in zip 08724 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881148484 | Elmhurst Operator LLC | Skilled Nursing Facility | 575 Route 70, 2nd Floor, Brick, NJ 08723-4042 | 2016-08-11 |
| 1538198312 | Cpl (laurelton Village) LLC | Skilled Nursing Facility | 475 Jack Martin Boulevard, Brick, NJ 08724-7732 | 2006-07-02 |
| 1790786572 | Meridian Nursing and Rehabilitation,inc. | Skilled Nursing Facility | 415 Jack Martin Blvd, Brick, NJ 08724-7732 | 2005-08-03 |
| 1174170336 | Complete Care At Shorrock, LLC | Skilled Nursing Facility | 75 Old Toms River Rd, Brick, NJ 08723-7800 | 2019-08-22 |
| 1679061030 | Complete Care At Laurelton LLC | Skilled Nursing Facility | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2018-05-01 |
| 1033620216 | Hmh Residential Care, Inc | Skilled Nursing Facility | 415 Jack Martin Blvd, Brick, NJ 08724-7732 | 2017-10-16 |
| 1710389739 | Willow Springs Operator, LLC | Skilled Nursing Facility | 1049 Burnt Tavern Rd, Brick, NJ 08724-1967 | 2014-09-22 |
| 1104172196 | Dr. Rashonda Flowers M.d. | Skilled Nursing Facility | 415 Jack Martin Blvd, Brick, NJ 08724-7732 | 2012-07-27 |
| 1346371812 | Laurelton Village | Skilled Nursing Facility | 475 Jack Martin Blvd, Brick, NJ 08724-7732 | 2007-03-08 |
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|---|---|---|---|---|
| 1124656202 | Bedrock Hcs At Daytona Fl LLC | Skilled Nursing Facility | 1776 Avenue of The States Ste 301, Lakewood, NJ 08701-4592 | 2020-04-01 |
| 1043847619 | Sycamore Rehabilitation and Assisted Living At East Hanover LLC | Skilled Nursing Facility | 1 S Ridgedale Ave, East Hanover, NJ 07936-3142 | 2020-03-24 |
| 1669029732 | Complete Care At Arbors, LLC | Skilled Nursing Facility | 1750 Route 37 W, Toms River, NJ 08757-2345 | 2019-08-22 |
| 1700444825 | Livingston Snf Amop, LLC | Skilled Nursing Facility | 348 E Cedar St, Livingston, NJ 07039-4221 | 2019-06-04 |
| 1639631104 | West Salem Operations LLC | Skilled Nursing Facility | 23 Shenandoah Dr, Lakewood, NJ 08701-4979 | 2019-04-03 |
| 1710441704 | Autumn Management LLC | Skilled Nursing Facility | 4201 Route 9, Howell, NJ 07731-3308 | 2019-01-24 |
| 1891274197 | Crest Pointe Operator LLC | Skilled Nursing Facility | 1515 Hulse Road, Point Pleasant, NJ 08742 | 2018-08-08 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1588163539 | Sinam | Skilled Nursing Facility | 153 Virginia St, Hillside, NJ 07205-2805 | 2018-02-06 |
| 1841701117 | Hmh Residential Care, Inc | Skilled Nursing Facility | 1725 Meridian Trl, Wall Township, NJ 07719-3869 | 2017-10-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.