Healthcare Provider Details

I. General information

NPI: 1306568951
Provider Name (Legal Business Name): ORCHARDS OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N COUNTY LINE RD
JACKSON NJ
08527-1264
US

IV. Provider business mailing address

14C 53RD ST STE 220
BROOKLYN NY
11232-2644
US

V. Phone/Fax

Practice location:
  • Phone: 732-367-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DOV GREEN
Title or Position: CEO
Credential:
Phone: 732-367-5400