Provider Demographics
NPI:1821697871
Name:HERITAGE OF CLARA BARTON CORP
Entity Type:Organization
Organization Name:HERITAGE OF CLARA BARTON CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACHORSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-335-6949
Mailing Address - Street 1:1015 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2825
Mailing Address - Country:US
Mailing Address - Phone:732-225-5990
Mailing Address - Fax:
Practice Address - Street 1:1015 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2825
Practice Address - Country:US
Practice Address - Phone:732-225-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility