- Enrollment id
- O20191212001476
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1407400674
- Multiple npi flag
- N
- Ccn
- 315234
- Associate id
- 5092148668
- Organization name
- ARBOR RIDGE OPERATOR LLC
- Doing business as name
- ARBOR RIDGE REHABILITATION AND HEALTHCARE CENTER
- Incorporation date
- 2019-08-06
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ARBOR RIDGE REHABILITATION AND HEALTHCARE CENTER
- Affiliation entity name
- MARQUIS HEALTH SERVICES
- Affiliation entity id
- 336
- Address line 1
- 261 TERHUNE DR
- City
- WAYNE
- State
- NJ
- Zip code
- 074707105