Healthcare Provider Details
I. General information
NPI: 1376533554
Provider Name (Legal Business Name): LUTHERAN SOCIAL MINISTRIES AT CRANE'S MILL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2005
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
459 PASSAIC AVE
WEST CALDWELL NJ
07006-7457
US
IV. Provider business mailing address
3 MANHATTAN DR
BURLINGTON NJ
08016-4119
US
V. Phone/Fax
- Phone: 973-276-6700
- Fax: 973-276-3003
- Phone: 609-781-1379
- Fax: 609-386-2305
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 306300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | 30A005 |
| License Number State | NJ |
VIII. Authorized Official
Name:
JEANNINE
RICHMAN
Title or Position: CFO
Credential:
Phone: 609-781-1379