# 3809 BAYSHORE ROAD OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENESIS NJ HOLDINGS LLC
- **Other names:** Victoria Manor
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649206327
- **Legal business name:** GENESIS NJ HOLDINGS LLC
- **Authorized official:** WALTER KIELER (PRESIDENT)
- **Authorized official phone:** (505) 468-4742

## Contact information

- **Practice address:** 3809 BAYSHORE RD, NORTH CAPE MAY, NJ 08204-3259
- **Practice address phone:** (609) 898-0677
- **Practice address fax:** (609) 898-1186
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-4436
- **Mailing address fax:** (610) 925-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060508 | NJ | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 06/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0006179000 | AMERIHEALTH | — |
| 01 | — | 000852 | HORIZON - SUB | — |
| 01 | — | 0261173 | MOLINA \# | NJ |
| 05 | — | 05400 | — | NJ |
| 01 | — | 315281 | HORIZON - SNF | — |
| 01 | — | 316929 | US FAMILY HEALTH PLAN | — |
| 01 | — | 4471709 | UNISYS \# | — |
| 01 | — | 489813 | AETNA-HMO | — |
| 01 | — | 62-1518645 | CONSUMER HEALTH NETWORK | — |