Provider Demographics
NPI:1861515439
Name:LITTLE NURSING HOME
Entity type:Organization
Organization Name:LITTLE NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CUMISKEY
Authorized Official - Suffix:I
Authorized Official - Credentials:LNHA
Authorized Official - Phone:973-744-5518
Mailing Address - Street 1:71 CHRISTOPHER ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4231
Mailing Address - Country:US
Mailing Address - Phone:973-744-5518
Mailing Address - Fax:973-744-2446
Practice Address - Street 1:71 CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4231
Practice Address - Country:US
Practice Address - Phone:973-744-5518
Practice Address - Fax:973-744-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060709314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility