Organization
BRISTOL GLEN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PETERSON (CHIEF FINANCIAL OFFICER)
(732) 922-9800
Entity
Organization
Contact information
Practice address
200 BRISTOL GLEN DR, NEWTON, NJ 07860-2329
(973) 300-5788
(973) 579-2357
Mailing address
205 JUMPING BROOK RD, NEPTUNE, NJ 07753-3197
(732) 922-9800
(732) 922-9804
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4504003
—
NJ
05
—
9030204
—
NJ
Enumeration date
10/31/2006
Last updated
10/30/2023
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