- Enrollment id
- O20240209001106
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1528705431
- Multiple npi flag
- N
- Ccn
- 315037
- Associate id
- 8022481308
- Organization name
- FAMILY OF CARING AT TEANECK LLC
- Incorporation date
- 2021-10-01
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- FAMILY OF CARING AT TEANECK LLC
- Affiliation entity name
- FAMILY OF CARING HEALTHCARE
- Affiliation entity id
- 220
- Address line 1
- 1101 TEANECK ROAD
- City
- TEANECK
- State
- NJ
- Zip code
- 076664800