Organization
CENTER STATE HEALTH GROUP INC.
Active
Other names
Country Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SWEENEY (CFO)
(908) 851-8355
Entity
Organization
Contact information
Practice address
16 WHITESVILLE RD, TOMS RIVER, NJ 08753-4107
(732) 736-5106
(732) 286-3165
Mailing address
54 NEWCOMBE ST, BELLEVILLE, NJ 07109-1236
(973) 450-2908
(973) 844-4705
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061503
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4494407
—
NJ
05
—
4494504
—
NJ
Enumeration date
07/10/2006
Last updated
01/14/2008
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