Healthcare Provider Details

I. General information

NPI: 1619018611
Provider Name (Legal Business Name): KAPSON CRANFORD CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 JACKSON DR
CRANFORD NJ
07016-3602
US

IV. Provider business mailing address

10 JACKSON DR
CRANFORD NJ
07016-3602
US

V. Phone/Fax

Practice location:
  • Phone: 908-709-4300
  • Fax: 908-709-1460
Mailing address:
  • Phone: 908-709-4300
  • Fax: 908-709-1460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number82472
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number82472
License Number StateNJ

VIII. Authorized Official

Name: MRS. MARIA JOHNSON
Title or Position: COMMUNITY BUSINESS DIRECTOR
Credential:
Phone: 908-709-4300