Provider Demographics
NPI:1356507669
Name:GARDEN TERRACE NURSING HOME
Entity Type:Organization
Organization Name:GARDEN TERRACE NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMMING
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN/LNHA
Authorized Official - Phone:973-635-0899
Mailing Address - Street 1:361 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2229
Mailing Address - Country:US
Mailing Address - Phone:973-635-0899
Mailing Address - Fax:973-635-6890
Practice Address - Street 1:361 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2229
Practice Address - Country:US
Practice Address - Phone:973-635-0899
Practice Address - Fax:973-635-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061403314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility