Provider Demographics
NPI:1821378209
Name:EAST BRUNSWICK SENIOR CARE, LLC
Entity Type:Organization
Organization Name:EAST BRUNSWICK SENIOR CARE, LLC
Other - Org Name:THE CHELSEA AT EAST BRUNSWICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-889-4200
Mailing Address - Street 1:606 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5422
Mailing Address - Country:US
Mailing Address - Phone:732-651-6100
Mailing Address - Fax:732-651-6446
Practice Address - Street 1:606 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5422
Practice Address - Country:US
Practice Address - Phone:732-651-6100
Practice Address - Fax:732-651-6446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CMG SENIOR CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50A000310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility