Provider Demographics
NPI:1811640287
Name:ARTIS SENIOR LIVING OF BRICK TOWNSHIP, LLC
Entity type:Organization
Organization Name:ARTIS SENIOR LIVING OF BRICK TOWNSHIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-372-0180
Mailing Address - Street 1:680 AMERICAN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4023
Mailing Address - Country:US
Mailing Address - Phone:215-372-0180
Mailing Address - Fax:
Practice Address - Street 1:466 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7733
Practice Address - Country:US
Practice Address - Phone:732-475-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARTIS HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility