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General NPI Number Information
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NPI Number | 1063556629
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Entity Type | Organization
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Legal Business Name | MARCUS L. WARD HOME
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 333 ELMWOOD AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2491
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Country | US
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Telephone | 973-762-5050
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Fax | 973-763-3155
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Provider Business Mailing Address
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Address Line | 333 ELMWOOD AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2491
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Country | US
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Telephone | 973-762-5050
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Fax | 973-763-3155
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Authorized Official
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Title or Position | CFO
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Name | MR. GARRETT T MIDGETT III
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Credential |
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Telephone | 732-430-3675
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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 | 30A000
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License Number State | NJ
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