Provider Demographics
NPI:1669936001
Name:HAMMONTON MANOR RHCF
Entity type:Organization
Organization Name:HAMMONTON MANOR RHCF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TISCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-4466
Mailing Address - Street 1:821 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1531
Practice Address - Country:US
Practice Address - Phone:732-364-4466
Practice Address - Fax:732-364-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging