- Enrollment id
- O20100107000400
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1174669204
- Multiple npi flag
- N
- Ccn
- 315502
- Associate id
- 1153230453
- Organization name
- CARE ONE AT TEANECK, LLC
- Doing business as name
- CARE ONE AT TEANECK
- Incorporation date
- 2001-12-05
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CAREONE AT TEANECK
- Affiliation entity name
- CAREONE
- Affiliation entity id
- 109
- Address line 1
- 544 TEANECK ROAD
- City
- TEANECK
- State
- NJ
- Zip code
- 076664141