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NPI Code Detail

MEDICARE: 25 EAST LINDSLEY ROAD OPERATIONS LLC

MEDICARE: 25 EAST LINDSLEY ROAD OPERATIONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility060706NJ

General Provider Information

NPI Number : 1689858078
Entity Type Code : Organization
Provider Name (Legal Business Name) : 25 EAST LINDSLEY ROAD OPERATIONS LLC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-612-5327
Provider Business Practice Location Address
First Line : 25 E LINDSLEY RD
Second Line :
City : CEDAR GROVE
State : NJ
Zip : 07009-1023
Country : US
Telephone Number : 973-256-7220
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : MICHAEL BERG
Credential :
Telephone Number : 610-444-6350
Provider Enumeration Date : 12/21/2007
Last Update Date : 06/23/2025

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Directions to “25 EAST LINDSLEY ROAD OPERATIONS LLC ” Practice Location

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