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General NPI Number Information
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NPI Number | 1699892315
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Entity Type | Organization
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Legal Business Name | MARGARET ANNA CUSACK CARE CENTER,INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 537 PAVONIA AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-1803
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Country | US
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Telephone | 201-653-8300
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Fax | 201-653-7705
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Provider Business Mailing Address
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Address Line | 537 PAVONIA AVENUE
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City | JERSEY CITY
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State | NJ
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Zip | 07306
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Country | US
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Telephone | 201-653-8300
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Fax | 201-653-7705
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANN TAYLOR
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Credential | L.N.H.A.
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Telephone | 201-653-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 030905
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License Number State | NJ
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