Provider Demographics
NPI:1992085062
Name:TINTON FALLS SENIOR CARE, LLC
Entity type:Organization
Organization Name:TINTON FALLS SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-889-4200
Mailing Address - Street 1:1 HARTFORD DR
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4941
Mailing Address - Country:US
Mailing Address - Phone:732-933-4700
Mailing Address - Fax:732-933-0999
Practice Address - Street 1:1 HARTFORD DR
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4941
Practice Address - Country:US
Practice Address - Phone:732-933-4700
Practice Address - Fax:732-933-0999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CMG CHELSEA SENIOR CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ55A00310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility