# THE ESTAUGH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medford Leas
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740279652
- **Authorized official:** MR. JEREMY M VICKERS (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (609) 654-3009

## Contact information

- **Practice address:** 1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
- **Practice address phone:** (609) 654-3000
- **Practice address fax:** (609) 654-7894
- **Mailing address:** 1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
- **Mailing address phone:** (609) 654-3000
- **Mailing address fax:** (609) 654-9673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 060308 | NJ | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 10/14/2005
- **Last updated:** 07/15/2022