Provider Demographics
NPI:1144846346
Name:HEBREW OLD AGE CENTER OF ATLANTIC CITY
Entity type:Organization
Organization Name:HEBREW OLD AGE CENTER OF ATLANTIC CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSTANT CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-748-4416
Mailing Address - Street 1:22 W JIMMIE LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9422
Mailing Address - Country:US
Mailing Address - Phone:609-748-4416
Mailing Address - Fax:609-404-4841
Practice Address - Street 1:22 W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9422
Practice Address - Country:US
Practice Address - Phone:609-748-4416
Practice Address - Fax:609-404-4841
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEBREW OLD AGE CENTER OF ATLANTIC CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility