Provider Demographics
NPI:1689162216
Name:ARTIS SENIOR LIVING OF EVESHAM, LLC
Entity Type:Organization
Organization Name:ARTIS SENIOR LIVING OF EVESHAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:YARISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-372-0178
Mailing Address - Street 1:680 AMERICAN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4023
Mailing Address - Country:US
Mailing Address - Phone:215-372-0178
Mailing Address - Fax:484-831-5398
Practice Address - Street 1:302 LIPPINCOTT DR
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-4116
Practice Address - Country:US
Practice Address - Phone:856-810-0007
Practice Address - Fax:856-810-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03A008310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility