Basic Information
| Provider Information | |||||||||
| NPI: | 1558406140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NJ RETIREMENT I LLC | ||||||||
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| OtherOrganizationName: | THE GARDENS AT CROSS KEYS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4550 LENA DR | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170554922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175915706 | ||||||||
| FaxNumber: | 7175915710 | ||||||||
| Practice Location | |||||||||
| Address1: | 3152 GLASSBORO CROSS KEYS ROAD | ||||||||
| Address2: | |||||||||
| City: | GLASSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563072100 | ||||||||
| FaxNumber: | 8563072400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MURRAY | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACCOUNTING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7175915706 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | 35A3302 | NJ | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.