Provider Demographics
NPI:1659456911
Name:ACTORS FUND OF AMERICA
Entity Type:Organization
Organization Name:ACTORS FUND OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STROHL
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:201-871-8882
Mailing Address - Street 1:155 175 W HUDSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-871-8882
Mailing Address - Fax:201-871-9511
Practice Address - Street 1:155 175 W HUDSON AVENUE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1609
Practice Address - Country:US
Practice Address - Phone:201-871-8882
Practice Address - Fax:201-871-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4465202Medicaid
NJ4465211OtherMEDICAID CPCH
NJ315377Medicare Oscar/Certification