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General NPI Number Information
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NPI Number | 1497505614
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Entity Type | Organization
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Legal Business Name | WG CRANFORD SH LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 10 JACKSON DR
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City | CRANFORD
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State | NJ
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Zip | 07016-3602
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Country | US
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Telephone | 908-709-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E MARKET ST STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40202-1968
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Country | US
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Telephone | 502-779-7341
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Fax |
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Authorized Official
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Title or Position | AR SUPPORT ANALYST
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Name | HOLLY DUNBAR
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Credential |
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Telephone | 502-779-7341
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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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