Healthcare Provider Details

I. General information

NPI: 1982155107
Provider Name (Legal Business Name): THE NEW GOLDEN ACRES SP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PROSPECT STREET
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

29 WHISPERING PINES LN
LAKEWOOD NJ
08701-1421
US

V. Phone/Fax

Practice location:
  • Phone: 845-356-2440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number620-F-091
License Number StateNY

VIII. Authorized Official

Name: JOSEPH SCHONBERGER
Title or Position: MEMBER
Credential:
Phone: 732-363-7770