Provider Demographics
NPI:1265737316
Name:SNH TEANECK TENANT LLC
Entity type:Organization
Organization Name:SNH TEANECK TENANT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:BILOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-8387
Mailing Address - Street 1:255 WASHINGTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1634
Mailing Address - Country:US
Mailing Address - Phone:617-796-8350
Mailing Address - Fax:
Practice Address - Street 1:655 POMANDER WALK
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-836-3634
Practice Address - Fax:201-836-9435
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SNH TEANECK TENANT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-21
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0327212Medicaid