Provider Demographics
NPI:1104506971
Name:CSH MARLTON LESSEE, LLC
Entity type:Organization
Organization Name:CSH MARLTON LESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF MANAGEMENT COMPANY
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-441-7667
Mailing Address - Street 1:5 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:EVESHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5688
Mailing Address - Country:US
Mailing Address - Phone:856-326-1491
Mailing Address - Fax:
Practice Address - Street 1:5 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-5688
Practice Address - Country:US
Practice Address - Phone:856-326-1491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility