# TAG SENIOR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clover Rest Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457593444
- **Authorized official:** ALVAN SMALL (ADMINISTRATOR)
- **Authorized official phone:** (732) 841-5483

## Contact information

- **Practice address:** 28 WASHINGTON ST, COLUMBIA, NJ 07832-2324
- **Practice address phone:** (908) 496-4307
- **Mailing address:** 28 WASHINGTON ST, COLUMBIA, NJ 07832-2324
- **Mailing address phone:** (908) 496-4307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 62104 | NJ | Yes |

## Other

- **Enumeration date:** 04/06/2009
- **Last updated:** 04/06/2009