Provider Demographics
NPI:1942290002
Name:COUNTY OF CUMBERLAND
Entity Type:Organization
Organization Name:COUNTY OF CUMBERLAND
Other - Org Name:CUMBERLAND MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATOTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-455-8000
Mailing Address - Street 1:154 SUNNY SLOPE DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-5732
Mailing Address - Country:US
Mailing Address - Phone:856-455-8000
Mailing Address - Fax:856-455-5493
Practice Address - Street 1:154 SUNNY SLOPE DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-5732
Practice Address - Country:US
Practice Address - Phone:856-455-8000
Practice Address - Fax:856-455-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ60603314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315396Medicare PIN