Organization
LAURELTON VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRAMELL C CLARK (REGIONAL RESIDENT ACCOUNTING MGR)
(856) 813-2000
Entity
Organization
Contact information
Practice address
475 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 458-6600
(732) 458-2674
Mailing address
525 FELLOWSHIP RD, MOUNT LAUREL, NJ 08054-3415
(856) 813-2000
(856) 813-2020
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061532
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4492706
—
NJ
Enumeration date
03/08/2007
Last updated
08/14/2007
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