Basic Information
| Provider Information | |||||||||
| NPI: | 1457720112 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HALLMARK CARE AND REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 MARLBORO RD | ||||||||
| Address2: | |||||||||
| City: | WOOD RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070751235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016351195 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1123 ROCKDALE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027402947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089977448 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2015 | ||||||||
| LastUpdateDate: | 03/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | AUGUSTYNIAK | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2016351195 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HAR CAPITAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.