Provider Demographics
NPI:1396176434
Name:THE WOODLANDS AT HAYES MILL, LLC
Entity type:Organization
Organization Name:THE WOODLANDS AT HAYES MILL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MURPHY
Authorized Official - Last Name:VANDERVELDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-753-2000
Mailing Address - Street 1:114 HAYES MILL RD
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2457
Mailing Address - Country:US
Mailing Address - Phone:856-753-2000
Mailing Address - Fax:
Practice Address - Street 1:114 HAYES MILL RD
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2457
Practice Address - Country:US
Practice Address - Phone:856-753-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060419314000000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315297Medicare Oscar/Certification