Provider Demographics
NPI:1508456112
Name:CLOVER HILL SENIOR LIVING, LLC
Entity Type:Organization
Organization Name:CLOVER HILL SENIOR LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-485-4000
Mailing Address - Street 1:794 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2722
Mailing Address - Country:US
Mailing Address - Phone:201-485-4000
Mailing Address - Fax:201-485-4001
Practice Address - Street 1:794 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2722
Practice Address - Country:US
Practice Address - Phone:201-485-4000
Practice Address - Fax:201-485-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home