Provider Demographics
NPI:1225413941
Name:WILLOW SPRINGS OPERATOR LLC
Entity Type:Organization
Organization Name:WILLOW SPRINGS OPERATOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-903-1958
Mailing Address - Street 1:1049 BURNT TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1967
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1049 BURNT TAVERN RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1967
Practice Address - Country:US
Practice Address - Phone:732-840-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJZBBGDW310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility