Provider Demographics
NPI:1427732684
Name:TERRACE AT BETH ABRAHAM VILLAGE LLC
Entity type:Organization
Organization Name:TERRACE AT BETH ABRAHAM VILLAGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:MANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-420-2512
Mailing Address - Street 1:1135 E VETERANS HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5090
Mailing Address - Country:US
Mailing Address - Phone:757-420-2512
Mailing Address - Fax:
Practice Address - Street 1:1049 COLLEGE PARK BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4468
Practice Address - Country:US
Practice Address - Phone:757-420-2512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility