1538359880 NPI number — MEADOWVIEW CARE CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538359880 NPI number — MEADOWVIEW CARE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEADOWVIEW CARE CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538359880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
319 SPOTSWOOD GRAVEL HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08831-2950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-521-4948
Provider Business Mailing Address Fax Number:
732-521-4313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
319 SPOTSWOOD GRAVEL HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08831-2950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-521-4948
Provider Business Practice Location Address Fax Number:
732-521-4313
Provider Enumeration Date:
08/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LASRIEDA
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR732
Authorized Official Telephone Number:
732-521-4948

Provider Taxonomy Codes

  • Taxonomy code: 320700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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