Organization
AT LIBERTY PLACE LLC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REMENDA RENEAKE CHARLES (CHEIF OF EXCEUTIVE)
(856) 294-7979
Entity
Organization
Contact information
Practice address
1655 SWEDESBORO AVE, PAULSBORO, NJ 08066-1533
(856) 294-7979
(856) 599-1379
Mailing address
1655 SWEDESBORO AVE, PAULSBORO, NJ 08066-1533
(856) 294-7979
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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