# LAURELTON VILLAGE

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

## Provider details

- **NPI number:** 1346371812
- **Authorized official:** MRS. TRAMELL C CLARK (REGIONAL RESIDENT ACCOUNTING MGR)
- **Authorized official phone:** (856) 813-2000

## Contact information

- **Practice address:** 475 JACK MARTIN BLVD, BRICK, NJ 08724-7732
- **Practice address phone:** (732) 458-6600
- **Practice address fax:** (732) 458-2674
- **Mailing address:** 525 FELLOWSHIP RD, MOUNT LAUREL, NJ 08054-3415
- **Mailing address phone:** (856) 813-2000
- **Mailing address fax:** (856) 813-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 061532 | NJ | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 08/14/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4492706 | — | NJ |