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Organization

475 JACK MARTIN BOULEVARD OPERATIONS LLC

Active
Parent organization
GENESIS NJ HOLDINGS LLC
Other names
Laurelton Village Care Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
GENESIS NJ HOLDINGS LLC
Authorized official
MICHAEL T BERG (ASSISTANT SECRETARY)
(505) 468-4742
Entity
Organization

Contact information

Practice address
475 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 458-6600
(732) 458-6601
Mailing address
475 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 458-6600
(732) 458-6601

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NJ

Other

Enumeration date
07/29/2015
Last updated
01/05/2016
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