493 Black Oak Ridge Road, LLC
NPI #1619362563 in Wayne, New Jersey
Provider Information
- NPI Number
- 1619362563
- Entity Type
- Organization
- Organization Name
- 493 Black Oak Ridge Road, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- 493 BLACK OAK RIDGE ROAD, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Mar 30, 2015
- Last Updated
- Mar 30, 2015
Practice Location
- Address
- 493 BLACK OAK RIDGE RD
- City
- Wayne
- State
- New Jersey
- ZIP Code
- 07470-6501
- Phone
- (973) 692-9500
Authorized Official
- Name
- ANDROSKY ALBERTO LUGO, ESQ
- Title
- EXECUTIVE VICE PRESIDENT & G.C.
- Phone
- (201) 242-4006
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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