Provider Demographics
NPI:1497977870
Name:GENERATIONS PLUS, LLC
Entity Type:Organization
Organization Name:GENERATIONS PLUS, LLC
Other - Org Name:WELLSPRINGS FOR SENIORS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:CULANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-317-1910
Mailing Address - Street 1:7905 BROWNING RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4323
Mailing Address - Country:US
Mailing Address - Phone:856-317-1910
Mailing Address - Fax:856-317-1926
Practice Address - Street 1:7905 BROWNING RD
Practice Address - Street 2:SUITE 220
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4323
Practice Address - Country:US
Practice Address - Phone:856-317-1910
Practice Address - Fax:856-317-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ96058109261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9058109Medicaid