Provider Demographics
NPI:1538140249
Name:APPLEWOOD VILLAGE INC.
Entity type:Organization
Organization Name:APPLEWOOD VILLAGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-580-3845
Mailing Address - Street 1:1 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3985
Mailing Address - Country:US
Mailing Address - Phone:732-303-7403
Mailing Address - Fax:732-303-1240
Practice Address - Street 1:1 APPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3985
Practice Address - Country:US
Practice Address - Phone:732-780-7370
Practice Address - Fax:732-303-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061343314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4487907Medicaid
315292Medicare Oscar/Certification