Healthcare Provider Details

I. General information

NPI: 1497896526
Provider Name (Legal Business Name): CHELSEA AT EAST BRUNSWICK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 CRANBURY RD
EAST BRUNSWICK NJ
08816-5422
US

IV. Provider business mailing address

606 CRANBURY RD
EAST BRUNSWICK NJ
08816-5422
US

V. Phone/Fax

Practice location:
  • Phone: 732-651-6100
  • Fax: 732-651-6446
Mailing address:
  • Phone: 732-651-6100
  • Fax: 732-651-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number50A000
License Number StateNJ

VIII. Authorized Official

Name: MRS. GLORIA ANN PETRO
Title or Position: EXECUTIVE DIRECTOR
Credential: CALA
Phone: 732-651-6100