Provider Demographics
NPI:1275930752
Name:SPRINGPOINT AT MONROE VILLAGE, INC.
Entity Type:Organization
Organization Name:SPRINGPOINT AT MONROE VILLAGE, INC.
Other - Org Name:MONROE VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. V.P./CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:T
Authorized Official - Last Name:MIDGETT
Authorized Official - Suffix:III
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 1:1 DAVID BRAINERD DR
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1927
Practice Address - Country:US
Practice Address - Phone:732-521-6407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X, 2251G0304X, 235Z00000X
NJ50A8312310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0124541Medicaid