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General NPI Number Information
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NPI Number | 1790855567
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Entity Type | Organization
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Legal Business Name | CEDAR CREST VILLAGE INC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 1 CEDAR CREST VILLAGE DRIVE ATTN: HOME HEALTH ADMINISTRATOR
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-2100
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Country | US
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Telephone | 973-831-3500
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Fax | 410-204-7237
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Provider Business Mailing Address
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Address Line | 1 CEDAR CREST VILLAGE DRIVE ATTN: EXECUTIVE DIRECTOR
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-2100
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Country | US
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Telephone | 973-831-3500
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Fax | 410-204-7237
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Authorized Official
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Title or Position | ASSISTANT TREASURER
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Name | CHRISTOPHER J RATHMANN
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Credential |
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Telephone | 410-402-2390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 24165
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License Number State | NJ
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