Provider Demographics
NPI:1851647333
Name:ATRIUM AT PRINCETON LLC
Entity Type:Organization
Organization Name:ATRIUM AT PRINCETON LLC
Other - Org Name:ATRIUM SENIOR LIVING OF PRINCETON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-3233
Mailing Address - Street 1:1000 WINDROW DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5007
Mailing Address - Country:US
Mailing Address - Phone:609-514-9111
Mailing Address - Fax:609-419-1326
Practice Address - Street 1:1000 WINDROW DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5007
Practice Address - Country:US
Practice Address - Phone:609-514-9111
Practice Address - Fax:609-419-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ90112310400000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0088650Medicaid