- Enrollment id
- O20240219000946
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1821868472
- Multiple npi flag
- N
- Ccn
- 315517
- Associate id
- 4880038801
- Organization name
- MOORESTOWN OPERATOR LLC
- Doing business as name
- TOTAL REHAB MOORESTOWN
- Incorporation date
- 2022-12-12
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- TOTAL REHAB MOORESTOWN
- Affiliation entity name
- PREFERRED CARE
- Affiliation entity id
- 409
- Address line 1
- 212 MARTER AVE
- City
- MOORESTOWN
- State
- NJ
- Zip code
- 080573114