Organization
SUNNYSIDE MANOR INC
Active
Other names
Sunnyside Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARYELLEN KEANE LNHA (ADMINISTRATOR)
(732) 528-9311
Entity
Organization
Contact information
Practice address
2500 RIDGEWOOD RD, WALL TOWNSHIP, NJ 07719-9600
(732) 528-9311
(732) 528-9026
Mailing address
2500 RIDGEWOOD RD, WALL TOWNSHIP, NJ 07719-9600
(732) 528-9311
(732) 528-9026
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061329
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7902506
—
NJ
01
—
9652
EMPIRE PROVIDER NUMBER
NJ
Enumeration date
01/29/2007
Last updated
07/21/2022
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