Provider Demographics
NPI:1710283676
Name:THREE WM OPERATING LLC
Entity Type:Organization
Organization Name:THREE WM OPERATING LLC
Other - Org Name:THREE WOODBURY MEWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL & IN-HOUSE COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-565-7821
Mailing Address - Street 1:124 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2768
Mailing Address - Country:US
Mailing Address - Phone:856-384-6600
Mailing Address - Fax:856-384-6648
Practice Address - Street 1:124 GREEN AVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-2768
Practice Address - Country:US
Practice Address - Phone:856-384-6600
Practice Address - Fax:856-384-6648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WMRE THREE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35A010310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility