113 South Route 73 Opco LLC
Skilled Nursing Facility in Voorhees, NJ. Organization (NPI-2).
NPI number1013786417
StatusActive
Last updated in NPPESDec 27, 2023
Details
- NPI
- 1013786417
- Entity type
- Organization (NPI-2)
- Legal business name
- 113 South Route 73 Opco LLC
- Organization subpart
- No
- Enumeration date
- Dec 27, 2023
- Certification date
- Dec 27, 2023
- Last updated
- Dec 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | – | – | |
| 385H00000X | Respite Care | – | – |
Other names
- The Subacute At Autumn Lake Healthcare (Doing Business As)
Practice location
113 Route 73Voorhees, NJ 08043-9573
Phone 856-809-3500
Mailing address
14c 53rd StBrooklyn, NY 11232-2646
Phone 877-567-0402
Authorized official
Sam Stern
Cfo
8775670402
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