Provider Demographics
NPI:1336226844
Name:BARTLEY ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:BARTLEY ASSISTED LIVING, LLC
Other - Org Name:THE ORCHARDS AT BARTLEY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-367-5400
Mailing Address - Street 1:100 N COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1264
Mailing Address - Country:US
Mailing Address - Phone:732-367-5400
Mailing Address - Fax:732-370-3284
Practice Address - Street 1:100 N COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1264
Practice Address - Country:US
Practice Address - Phone:732-367-5400
Practice Address - Fax:732-370-3284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8703507Medicaid