Organization
THE ESTAUGH
Active
Other names
Medford Leas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY M VICKERS (CHIEF EXECUTIVE OFFICER)
(609) 654-3009
Entity
Organization
Contact information
Practice address
1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
(609) 654-3000
(609) 654-7894
Mailing address
1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
(609) 654-3000
(609) 654-9673
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
060308
NJ
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/14/2005
Last updated
07/15/2022
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