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Organization
521 PINE BROOK OPERATING, LLC
Active
Organization
521 PINE BROOK OPERATING, LLC
Active
Parent organization
521 PINE BROOK VENTURES, LLC
Other names
Lincoln Park Renaissance
Organization subpart
Yes
Provider details
NPI number
Legal business name
521 PINE BROOK VENTURES, LLC
Authorized official
CHARLES-EDOUARD GROS (MANAGING MEMBER)
(973) 696-3300
Entity
Organization
Contact information
Practice address
521 PINE BROOK RD, LINCOLN PARK, NJ 07035-1801
(973) 696-3300
Mailing address
499 PINE BROOK RD, LINCOLN PARK, NJ 07035-1804
(973) 696-3300
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061408
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01216893
—
NY
05
—
4491904
—
NJ
Enumeration date
12/26/2012
Last updated
12/26/2012
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