Provider Demographics
NPI:1073500153
Name:SPRINGPOINT AT CRESTWOOD, INC.
Entity Type:Organization
Organization Name:SPRINGPOINT AT CRESTWOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-430-3675
Mailing Address - Street 1:4814 OUTLOOK DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6812
Mailing Address - Country:US
Mailing Address - Phone:732-430-3650
Mailing Address - Fax:732-430-3711
Practice Address - Street 1:50 LACEY RD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2951
Practice Address - Country:US
Practice Address - Phone:732-849-4900
Practice Address - Fax:732-849-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4492803Medicaid
NJ4492803Medicaid