Provider Demographics
NPI:1164962734
Name:UNITED METHODIST HOMES OF NEW JERSEY
Entity Type:Organization
Organization Name:UNITED METHODIST HOMES OF NEW JERSEY
Other - Org Name:UNITED METHODIST COMMUNITIES AT THE SHORES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-922-9800
Mailing Address - Street 1:205 JUMPING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3197
Mailing Address - Country:US
Mailing Address - Phone:732-922-9800
Mailing Address - Fax:732-922-9804
Practice Address - Street 1:2201 BAY AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-2568
Practice Address - Country:US
Practice Address - Phone:609-399-8505
Practice Address - Fax:609-391-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ030501314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4471903Medicaid