Provider Demographics
NPI:1194126102
Name:SPRING MEADOWS SUMMIT
Entity type:Organization
Organization Name:SPRING MEADOWS SUMMIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-522-8852
Mailing Address - Street 1:41 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4038
Mailing Address - Country:US
Mailing Address - Phone:908-522-8852
Mailing Address - Fax:
Practice Address - Street 1:41 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4038
Practice Address - Country:US
Practice Address - Phone:908-522-8852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL SENIOR LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ90A001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility