Healthcare Provider Details

I. General information

NPI: 1184482176
Provider Name (Legal Business Name): CSH PASCACK LESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 PASCACK RD
TOWNSHIP OF WASHINGTON NJ
07676-4323
US

IV. Provider business mailing address

620 PASCACK RD
TOWNSHIP OF WASHINGTON NJ
07676-4323
US

V. Phone/Fax

Practice location:
  • Phone: 201-263-1955
  • Fax: 201-620-2898
Mailing address:
  • Phone: 201-263-1955
  • Fax: 201-620-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER BERNIER
Title or Position: PRESIDENT AND COO
Credential:
Phone: 908-889-4200