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General NPI Number Information
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NPI Number | 1104335850
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Entity Type | Organization
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Legal Business Name | 201 NEW ROAD OPERATIONS LLC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 201 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1201
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Country | US
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Telephone | 609-927-6131
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Fax |
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Provider Business Mailing Address
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Address Line | 201 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1201
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Country | US
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Telephone | 609-927-6131
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Fax |
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Authorized Official
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Title or Position | VP GEN COUNSEL ASST SECY
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Name | MICHAEL T BERG
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Credential |
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Telephone | 505-468-4742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 00000
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License Number State | NJ
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