Organization
SENIOR CARE & ACTIVITIES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK ROBERT JENNY (EXECUTIVE DIRECTOR)
(973) 783-5589
Entity
Organization
Contact information
Practice address
110 GREENWOOD AVE, MONTCLAIR, NJ 07042-4010
(973) 783-5589
(973) 783-3711
Mailing address
110 GREENWOOD AVE, MONTCLAIR, NJ 07042-4010
(973) 783-5589
(973) 783-3711
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
308119
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073016
—
NJ
Enumeration date
04/10/2007
Last updated
08/22/2020
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