Provider Demographics
NPI:1225436215
Name:112 FRANKLIN CORNER ROAD OPERATING COMPANY LLC
Entity Type:Organization
Organization Name:112 FRANKLIN CORNER ROAD OPERATING COMPANY LLC
Other - Org Name:ATRIUM POST ACUTE CARE OF LAWRENCEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CONTRACT MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-3233
Mailing Address - Street 1:112 FRANKLIN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2104
Mailing Address - Country:US
Mailing Address - Phone:609-896-1494
Mailing Address - Fax:609-895-0158
Practice Address - Street 1:112 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2104
Practice Address - Country:US
Practice Address - Phone:609-896-1494
Practice Address - Fax:609-895-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061104314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315113Medicare Oscar/Certification