Healthcare Provider Details

I. General information

NPI: 1588898886
Provider Name (Legal Business Name): FOREST MANOR MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 STATE PARK RD
BLAIRSTOWN NJ
07825-4206
US

IV. Provider business mailing address

PO BOX 283
HOPE NJ
07844-0283
US

V. Phone/Fax

Practice location:
  • Phone: 908-459-4128
  • Fax:
Mailing address:
  • Phone: 908-459-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ZEV FARKAS
Title or Position: MANAGING MEMBER
Credential:
Phone: 908-459-4128