Healthcare Provider Details
I. General information
NPI: 1316946007
Provider Name (Legal Business Name): CARE ONE AT MADISON AVENUE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2005
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 MADISON AVENUE
MORRISTOWN NJ
07960
US
IV. Provider business mailing address
151 MADISON AVENUE
MORRISTOWN NJ
07960
US
V. Phone/Fax
- Phone: 973-656-2700
- Fax: 973-656-2710
- Phone: 973-656-2700
- Fax: 973-656-2710
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: MR.
A.
ALBERTO
LUGO
Title or Position: EXECUTIVE VP & GENERAL COUNSEL
Credential:
Phone: 201-242-4000