Healthcare Provider Details

I. General information

NPI: 1952397309
Provider Name (Legal Business Name): SENIORCARE OF HAMILTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 EDINBURG RD
HAMILTON SQUARE NJ
08690-1229
US

IV. Provider business mailing address

1059 EDINBURG RD
HAMILTON SQUARE NJ
08690-1229
US

V. Phone/Fax

Practice location:
  • Phone: 609-588-0091
  • Fax:
Mailing address:
  • Phone: 609-588-0091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061111
License Number StateNJ

VIII. Authorized Official

Name: JOSEF BOGDAN
Title or Position: LNHA
Credential:
Phone: 609-588-0091