11 History Lane Operating Company, LLC
NPI #1932108693 in Jackson, New Jersey
Provider Information
- NPI Number
- 1932108693
- Entity Type
- Organization
- Organization Name
- 11 History Lane Operating Company, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 15, 2005
- Last Updated
- Aug 13, 2015
Practice Location
- Address
- 11 HISTORY LANE
- City
- Jackson
- State
- New Jersey
- ZIP Code
- 08527
- Phone
- (732) 367-6600
Authorized Official
- Name
- MR. A. ALBERTO LUGO
- Title
- EXECUTIVE VP & GENERAL COUNSEL
- Phone
- (201) 242-4000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Respite Care |
| Skilled Nursing Facility |
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