Provider Demographics
NPI:1679286249
Name:WHITE HOUSE HEALTHCARE CENTER LLC
Entity type:Organization
Organization Name:WHITE HOUSE HEALTHCARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:COLEV
Authorized Official - Middle Name:J
Authorized Official - Last Name:GESTETNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-600-2030
Mailing Address - Street 1:560 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-2109
Mailing Address - Country:US
Mailing Address - Phone:973-672-6500
Mailing Address - Fax:973-789-3017
Practice Address - Street 1:560 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-2109
Practice Address - Country:US
Practice Address - Phone:973-672-6500
Practice Address - Fax:973-789-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility