Provider Demographics
NPI:1922125558
Name:CA EAST BRUNSWICK LLC
Entity Type:Organization
Organization Name:CA EAST BRUNSWICK LLC
Other - Org Name:THE CHELSEA AT EAST BRUNSWICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-522-0808
Mailing Address - Street 1:33 UNION PL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3650
Mailing Address - Country:US
Mailing Address - Phone:908-522-0808
Mailing Address - Fax:908-522-5565
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50A000310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7657901Medicaid