Provider Demographics
NPI:1144264912
Name:HEALTH RESOURCES OF FAIR LAWN, LLC
Entity type:Organization
Organization Name:HEALTH RESOURCES OF FAIR LAWN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:12-15 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5808
Practice Address - Country:US
Practice Address - Phone:201-797-9522
Practice Address - Fax:201-703-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060224314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ02320Medicaid
A382714OtherOXFORD HEALTH PLANS
1007223OtherAETNA-HMO
000508OtherHORIZION - SUB
0006243000OtherAMERIHEALTH
4464401OtherUNISYS #
326922OtherUS FAMILY HEALTH PLAN
315328OtherHORIZON - SNF
4464401OtherUNISYS #
=========OtherCIGNA-NJ
315328OtherHORIZON - SNF
=========OtherAETNA-NONHMO
=========OtherHCPC
000508OtherHORIZION - SUB
1007223OtherAETNA-HMO
NJ02320Medicaid