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General NPI Number Information
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NPI Number | 1013441278
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Entity Type | Organization
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Legal Business Name | FIVE STAR QUALITY CARE-NJ, LLC
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 501 LAUREL OAK RD
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City | VOORHEES
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State | NJ
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Zip | 08043-4418
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Country | US
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Telephone | 856-566-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CENTRE ST
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City | NEWTON
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State | MA
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Zip | 02458-2094
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Country | US
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Telephone | 617-796-8387
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | KATHERINE E POTTER
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Credential |
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Telephone | 617-796-8387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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