Provider Demographics
NPI:1205172954
Name:TOWN SQUARE ADULT MEDICAL DAY CARE CENTER INC.
Entity type:Organization
Organization Name:TOWN SQUARE ADULT MEDICAL DAY CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-736-5301
Mailing Address - Street 1:1155 E JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1155 E JERSEY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2310
Practice Address - Country:US
Practice Address - Phone:908-787-0980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20004261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care