Provider Demographics
NPI:1053456012
Name:GENERATIONS ADULT DAY HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GENERATIONS ADULT DAY HEALTH SERVICES LLC
Other - Org Name:GENERATIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER,OWNER,ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALDARALE-AHEARN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:609-653-9700
Mailing Address - Street 1:40 E NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2341
Mailing Address - Country:US
Mailing Address - Phone:609-653-9700
Mailing Address - Fax:
Practice Address - Street 1:40 E NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2341
Practice Address - Country:US
Practice Address - Phone:609-653-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ018101261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8481709OtherMEDICAID PROVIDER NUMBER
NJ018101OtherSTATE LICENSE NUMBER