Healthcare Provider Details

I. General information

NPI: 1487794038
Provider Name (Legal Business Name): ZIRBSER - GREENBRIAR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ROUTE 206
HAMMONTON NJ
08037-2722
US

IV. Provider business mailing address

45 ROUTE 206
HAMMONTON NJ
08037-2722
US

V. Phone/Fax

Practice location:
  • Phone: 609-561-8977
  • Fax: 609-561-1158
Mailing address:
  • Phone: 609-561-8977
  • Fax: 609-561-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number018102
License Number StateNJ

VIII. Authorized Official

Name: MS. PHYLLIS R. FISHER
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 609-561-8977