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General NPI Number Information
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NPI Number | 1891824835
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Entity Type | Organization
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Legal Business Name | SHORE WINDS CORP
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 205 W PARKWAY DR
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City | EGG HARBOR TWP
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State | NJ
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Zip | 08234-5105
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Country | US
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Telephone | 609-484-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 29 BERKSHIRE DR
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City | SEWELL
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State | NJ
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Zip | 08080-3102
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Country | US
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Telephone | 609-484-3311
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MS. SUSAN E MACDONALD
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Credential |
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Telephone | 609-484-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 018253
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License Number State | NJ
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