- Enrollment id
- O20240122002106
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1962157909
- Multiple npi flag
- N
- Ccn
- 315110
- Associate id
- 2567814932
- Organization name
- COMPLETE CARE AT LAKEVIEW LLC
- Doing business as name
- COMPLETE CARE AT WAYNE HILLS REHABILITATION & RESPIRATORY CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COMPLETE CARE AT WAYNE HILLS REHAB & RESP CENTER
- Affiliation entity name
- COMPLETE CARE
- Affiliation entity id
- 157
- Address line 1
- 130 TERHUNE DR
- City
- WAYNE
- State
- NJ
- Zip code
- 074707104