Provider Demographics
NPI:1346007689
Name:MATAWAN ALF OPERATIONS LLC
Entity Type:Organization
Organization Name:MATAWAN ALF OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PINCHOS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-783-3110
Mailing Address - Street 1:40 FRENEAU AVE
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-4500
Mailing Address - Country:US
Mailing Address - Phone:732-566-0800
Mailing Address - Fax:
Practice Address - Street 1:40 FRENEAU AVE
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-4500
Practice Address - Country:US
Practice Address - Phone:732-566-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility