- Enrollment id
- O20060209000669
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1821097387
- Multiple npi flag
- N
- Ccn
- 315092
- Associate id
- 8325053481
- Organization name
- HCC LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CAREONE AT HOLMDEL
- Affiliation entity name
- CAREONE
- Affiliation entity id
- 109
- Address line 1
- 188 STATE ROUTE 34
- City
- HOLMDEL
- State
- NJ
- Zip code
- 077332125