Provider Demographics
NPI:1336120948
Name:HEALTH AFFILIATES, INC.
Entity Type:Organization
Organization Name:HEALTH AFFILIATES, INC.
Other - Org Name:THE MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TONI LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-303-5050
Mailing Address - Street 1:689 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2511
Mailing Address - Country:US
Mailing Address - Phone:732-431-5200
Mailing Address - Fax:732-409-2446
Practice Address - Street 1:689 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2511
Practice Address - Country:US
Practice Address - Phone:732-431-5200
Practice Address - Fax:732-409-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061307314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4489802Medicaid
NJ4489802Medicaid