# MERRY HEART TALLY HO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MERRY HEART OF BOONTON TWP.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245310788
- **Authorized official:** MS. BARBARA MONTILLA BONIFACIO R.N., L.N.H.A. (ADMINISTRATOR)
- **Authorized official phone:** (973) 334-2454

## Contact information

- **Practice address:** 199 POWERVILLE RD, BOONTON, NJ 07005-8840
- **Practice address phone:** (973) 334-2454
- **Practice address fax:** (973) 402-0719
- **Mailing address:** 199 POWERVILLE RD, BOONTON, NJ 07005-8840
- **Mailing address phone:** (973) 334-2454
- **Mailing address fax:** (973) 402-0719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 061415 | NJ | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0074063 | — | NJ |