Healthcare Provider Details

I. General information

NPI: 1215014048
Provider Name (Legal Business Name): UNITED METHODIST HOMES OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 STOCKTON AVE
OCEAN GROVE NJ
07756-1150
US

IV. Provider business mailing address

3311 STATE ROUTE 33
NEPTUNE NJ
07753-3440
US

V. Phone/Fax

Practice location:
  • Phone: 732-774-1316
  • Fax: 732-776-6313
Mailing address:
  • Phone: 732-922-9802
  • Fax: 732-922-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number310400000X
License Number StateNJ

VIII. Authorized Official

Name: MR. RICHARD D WILSON
Title or Position: VP FINANCE
Credential:
Phone: 732-922-9802