Healthcare Provider Details

I. General information

NPI: 1720450794
Provider Name (Legal Business Name): 3000 HILLTOP ROAD OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 01/23/2017
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 TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number658334
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNJ

VIII. Authorized Official

Name: MICHAEL T BERG
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 505-468-4742