Provider Demographics
NPI:1770312415
Name:LCS FLORHAM PARK LLC
Entity type:Organization
Organization Name:LCS FLORHAM PARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:VICTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4500
Mailing Address - Street 1:110 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1116
Mailing Address - Country:US
Mailing Address - Phone:973-944-0909
Mailing Address - Fax:
Practice Address - Street 1:110 PARK AVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1116
Practice Address - Country:US
Practice Address - Phone:973-944-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility