TRC Realty Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

90115 Issued in NJ

Legal business name

TRC REALTY CORP

Doing business as

Bayside Manor Assisted Living Facility

Practice address

7 Laurel Ave
Keansburg, NJ 07734-1122

Phone

(732) 471-1600

Fax

(732) 471-1077

NPI assigned

Feb 8, 2007

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Anthony Joseph Cappadona, NJCALA

Title

Administrator Owner

Phone

(732) 471-1600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bayside Manor Assisted Living Facility Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1003956806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LAUREL AVE",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341122",
            "telephone_number": "732-471-1600",
            "fax_number": "732-471-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LAUREL AVE",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341122",
            "telephone_number": "732-471-1600",
            "fax_number": "732-471-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRC REALTY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "CAPPADONA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "732-471-1600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NJCALA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "90115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7279001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Manor Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Keansburg, NJ
• Providers in Keansburg, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.