Provider Demographics
NPI:1205170735
Name:CRANFORD NH LLC
Entity type:Organization
Organization Name:CRANFORD NH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KURLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-881-8940
Mailing Address - Street 1:102 REAGAN CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3263
Mailing Address - Country:US
Mailing Address - Phone:732-881-8940
Mailing Address - Fax:
Practice Address - Street 1:205 BIRCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2515
Practice Address - Country:US
Practice Address - Phone:908-272-6660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ062006314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315091Medicare Oscar/Certification