Healthcare Provider Details

I. General information

NPI: 1609558527
Provider Name (Legal Business Name): SNH NJ TENANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 ROUTE 70
LAKEWOOD NJ
08701-5949
US

IV. Provider business mailing address

1400 ROUTE 70
LAKEWOOD NJ
08701-5949
US

V. Phone/Fax

Practice location:
  • Phone: 732-370-0444
  • Fax:
Mailing address:
  • Phone: 732-370-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER F. MINTZER
Title or Position: PRESIDENT & CHIEF OPERATING OFFICER
Credential:
Phone: 617-796-8350