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General NPI Number Information
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NPI Number | 1073259602
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Entity Type | Organization
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Legal Business Name | HACKENSACK MERIDIAN LIVING AT HOLMDEL, LLC
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 200 COMMONS WAY
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City | HOLMDEL
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State | NJ
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Zip | 07733
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Country | US
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Telephone | 862-682-4386
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Fax | 732-334-3000
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Provider Business Mailing Address
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Address Line | 200 COMMONS WAY
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City | HOLMDEL
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State | NJ
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Zip | 07733
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Country | US
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Telephone | 862-682-4386
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Fax | 732-334-3000
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVEN BAKER
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Credential |
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Telephone | 862-682-4386
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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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