Provider Demographics
NPI:1053925024
Name:LINCOLNWOOD OPERATOR, LLC
Entity type:Organization
Organization Name:LINCOLNWOOD OPERATOR, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RISK MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUNDLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-903-1985
Mailing Address - Street 1:1608 ROUTE 88 STE 301
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3009
Mailing Address - Country:US
Mailing Address - Phone:732-903-1985
Mailing Address - Fax:
Practice Address - Street 1:610 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-3820
Practice Address - Country:US
Practice Address - Phone:401-353-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-07
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility