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NPI Provider: 1932108693
Contact Name: Breslin P Kevin
Position: Executive VP
Phone: (201) 242-4004
11 History Lane Operating Company, Llc Information:
11 History Lane Operating Company, Llc organization have npi 1932108693, taxonomy code is 314000000X with license number is in . This Business address located in 11 History Ln, Jackson, NJ 85272 New Jersey. Get directions of 11 History Lane Operating Company, Llc.
Practice Location
Address: 11 History Ln, Jackson, NJ 85272
Phone: (732) 367-6600
Business Location
Address: 11 History Ln, Jackson, NJ 85272
Phone: (732) 367-6600
Fax: (732) 905-9641
Taxonomy
Taxonomy Code: 314000000X
License Number:
License Number of State: NJ
Primary Taxonomy Switch: Y
Enumeration Date: 7/15/2005
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