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General NPI Number Information
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NPI Number | 1891814406
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Entity Type | Organization
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Legal Business Name | JUNIPER VILLAGE AT WILLIAMSTOWN LLC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 1648 S BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9247
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Country | US
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Telephone | 856-740-4444
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Fax | 856-740-4445
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Provider Business Mailing Address
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Address Line | 1648 S BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9247
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Country | US
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Telephone | 856-740-4444
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Fax | 856-740-4445
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Authorized Official
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Title or Position | SECRETATY
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Name | LINDA C. DONATO
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Credential |
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Telephone | 973-945-3526
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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 | 35A004
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License Number State | NJ
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