Organization
11 HISTORY LANE OPERATING COMPANY, LLC
Active
Other names
Care One at Jackson Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
ANDROVSKY ALBERTO LUGO ESQ. (GENERAL COUNSEL/EXECUTIVE VICE PRES)
(201) 242-4006
Entity
Organization
Contact information
Practice address
11 HISTORY LANE, JACKSON, NJ 08527
(732) 367-6600
(732) 905-9641
Mailing address
11 HISTORY LANE, JACKSON, NJ 08527
(732) 367-6600
(732) 905-9641
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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