Provider Demographics
NPI:1306195391
Name:LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-499-3879
Mailing Address - Street 1:377 JERSEY AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-499-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SENIOR LIFE @ JERSEY CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization