# 69 MAPLE AVE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073505970
- **Authorized official:** MRS. BETH GOLDMAN (CONTROLLER)
- **Authorized official phone:** (732) 446-1804

## Contact information

- **Practice address:** 69 MAPLE RD, WEST MILFORD, NJ 07480-2707
- **Practice address phone:** (973) 697-5640
- **Practice address fax:** (973) 697-8607
- **Mailing address:** 104 PENSION RD, ENGLISHTOWN, NJ 07726-8400
- **Mailing address phone:** (732) 446-1804
- **Mailing address fax:** (732) 446-0999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2005
- **Last updated:** 10/20/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4496906 | — | NJ |