Organization
TI HEALTHCARE I LLC
Active
Other names
Forest Manor Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A NICHOLSON (MANAGER)
(908) 459-4128
Entity
Organization
Contact information
Practice address
145 STATE PARK ROAD, BLAIRSTOWN, NJ 07825-4206
(908) 459-4128
(908) 459-4513
Mailing address
PO BOX 283, HOPE, NJ 07844-0283
(908) 459-4128
(908) 459-4513
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
062103
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9032401
—
NJ
Enumeration date
04/02/2007
Last updated
08/22/2020
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