Provider Demographics
NPI:1821524117
Name:OCEAN GROVE OPERATING LLC
Entity Type:Organization
Organization Name:OCEAN GROVE OPERATING LLC
Other - Org Name:ALLEGRIA AT OCEAN GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TENNENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-371-9500
Mailing Address - Street 1:70 STOCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07756-1150
Mailing Address - Country:US
Mailing Address - Phone:732-774-1316
Mailing Address - Fax:
Practice Address - Street 1:70 STOCKTON AVE
Practice Address - Street 2:
Practice Address - City:OCEAN GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07756-1150
Practice Address - Country:US
Practice Address - Phone:732-774-1316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility