Provider Demographics
NPI:1508448697
Name:LCS BRIDGEWATER OPERATIONS II LLC
Entity Type:Organization
Organization Name:LCS BRIDGEWATER OPERATIONS II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP, TREASURER, MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4619
Mailing Address - Street 1:400 LOCUST ST STE 820
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 FRONTIER RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2936
Practice Address - Country:US
Practice Address - Phone:732-507-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)