Organization
FS LEISURE PARK TENANT TRUST
Active
Parent organization
FS LEISURE PARK TENANT TRUST
Other names
Leisure Park Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FS LEISURE PARK TENANT TRUST
Authorized official
KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8387
Entity
Organization
Contact information
Practice address
1400 HIGHWAY 70, LAKEWOOD, NJ 08701-5949
(732) 370-0444
(732) 370-1783
Mailing address
1400 HIGHWAY 70, LAKEWOOD, NJ 08701-5949
(732) 370-0444
(732) 370-1783
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
03/26/2019
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