Organization
BRISTOL GLEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT PETERSON (CHIEF FINANCIAL OFFICER)
(732) 922-2980
Entity
Organization
Contact information
Practice address
200 BRISTOL GLEN DRIVE, NEWTON, NJ 07860
(973) 300-5788
Mailing address
205 JUMPING BROOK RD, NEPTUNE, NJ 07753-3197
(732) 922-9800
(732) 922-9804
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
85A001
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4504003
—
NJ
Enumeration date
04/20/2015
Last updated
10/30/2023
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