Provider Demographics
NPI:1376543462
Name:COUNTY OF ATLANTIC
Entity Type:Organization
Organization Name:COUNTY OF ATLANTIC
Other - Org Name:MEADOWVIEW NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPTROLLER/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:CCFO
Authorized Official - Phone:609-343-2258
Mailing Address - Street 1:235 DOLPHIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-2015
Mailing Address - Country:US
Mailing Address - Phone:609-645-5955
Mailing Address - Fax:609-645-5939
Practice Address - Street 1:235 DOLPHIN AVE
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2015
Practice Address - Country:US
Practice Address - Phone:609-645-5955
Practice Address - Fax:609-645-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060101314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315358Medicare Oscar/Certification