Organization
CHESTNUT HILL RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER S REQUEJO (CONTROLLER)
(973) 777-7800
Entity
Organization
Contact information
Practice address
338 CHESTNUT ST, PASSAIC, NJ 07055-3158
(973) 777-7800
(973) 778-9013
Mailing address
338 CHESTNUT ST, PASSAIC, NJ 07055-3158
(973) 777-7800
(973) 778-9013
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
16A001
NJ
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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