Healthcare Provider Details

I. General information

NPI: 1295201226
Provider Name (Legal Business Name): 3000 HILLTOP ROAD OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HILLTOP RD
WHITING NJ
08759-1349
US

IV. Provider business mailing address

3000 HILLTOP RD
WHITING NJ
08759-1349
US

V. Phone/Fax

Practice location:
  • Phone: 732-849-4400
  • Fax: 732-849-4401
Mailing address:
  • Phone: 732-849-4400
  • Fax: 732-849-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL THEODORE BERG
Title or Position: OFFICER
Credential:
Phone: 505-468-4742