Provider Demographics
NPI:1215217690
Name:WARREN SENIOR CARE, LLC
Entity Type:Organization
Organization Name:WARREN SENIOR CARE, LLC
Other - Org Name:THE CHELSEA AT WARREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-889-4200
Mailing Address - Street 1:274 KING GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5157
Mailing Address - Country:US
Mailing Address - Phone:908-903-0911
Mailing Address - Fax:908-903-1433
Practice Address - Street 1:274 KING GEORGE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5157
Practice Address - Country:US
Practice Address - Phone:908-903-0911
Practice Address - Fax:908-903-1433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CMG CHELSEA SENIOR CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ80A003310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility