Organization
BEACON OF LIFE CENTRAL NJ
Active
Other names
BoldAge PACE Central NJ, BoldAge PACE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CZERMAK (CHIEF ADMINISTRATIVE OFFICER)
(855) 801-2653
Entity
Organization
Contact information
Practice address
1075 STEPHENSON AVE, OCEANPORT, NJ 07757
(732) 592-3400
Mailing address
106 W MOORE AVE, MOORESVILLE, NC 28115-3551
(732) 806-3205
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
09/02/2015
Last updated
04/10/2025
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