- Enrollment id
- O20240717001355
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1891406013
- Multiple npi flag
- N
- Ccn
- 315521
- Associate id
- 0840735544
- Organization name
- WOODBURY SNF OPERATIONS LLC
- Doing business as name
- ATLAS POST ACUTE AT WOODBURY COUNTRY CLUB
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ATLAS POST ACUTE AT WOODBURY COUNTRY CLUB
- Affiliation entity name
- ATLAS HEALTHCARE
- Affiliation entity id
- 598
- Address line 1
- 467 COOPER ST
- City
- WOODBURY
- State
- NJ
- Zip code
- 080962519