Provider Demographics
NPI:1932450863
Name:ATRIUM AT MATAWAN
Entity Type:Organization
Organization Name:ATRIUM AT MATAWAN
Other - Org Name:ATRIUM POST ACUTE CARE OF MATAWAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-3233
Mailing Address - Street 1:38 FRENEAU AVE
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3323
Mailing Address - Country:US
Mailing Address - Phone:732-765-5600
Mailing Address - Fax:732-441-4170
Practice Address - Street 1:38 FRENEAU AVE
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3323
Practice Address - Country:US
Practice Address - Phone:732-765-5600
Practice Address - Fax:732-441-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ556200314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0225797Medicaid