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General NPI Number Information
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NPI Number | 1740650837
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Entity Type | Organization
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Legal Business Name | FSP-MARLBORO LICENSEE, LLC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 52 COUNTY ROAD 520
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1203
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Country | US
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Telephone | 732-536-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 52 COUNTY ROAD 520
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1203
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Country | US
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Telephone | 732-536-3000
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED SIGNER
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Name | MARK T SPIEGEL
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Credential |
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Telephone | 770-777-9898
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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 | 13A014
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License Number State | NJ
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