Provider Demographics
NPI:1942489661
Name:CARE ONE AT EVESHAM ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:CARE ONE AT EVESHAM ASSISTED LIVING, LLC
Other - Org Name:CARE ONE AT EVESHAM ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP & GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:A.
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-242-4000
Mailing Address - Street 1:870 E. ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-988-2400
Mailing Address - Fax:856-988-2180
Practice Address - Street 1:870 E. ROUTE 70
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-988-2400
Practice Address - Fax:856-988-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility