Presbyterian Homes of Southern New Jersey, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PRESBYTERIAN HOMES OF SOUTHERN NEW JERSEY, INC

Practice address

132 Warwick Rd
Haddonfield, NJ 08033-3707

Phone

(856) 429-5500

Fax

(856) 429-1097

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Puma

Title

President-Ceo

Phone

(609) 987-8900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1013086586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ROSZEL RD",
            "address_2": "SUITE C120",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406211",
            "telephone_number": "609-987-8900",
            "fax_number": "609-720-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 WARWICK RD",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080333707",
            "telephone_number": "856-429-5500",
            "fax_number": "856-429-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES OF SOUTHERN NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "PUMA",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT-CEO",
        "authorized_official_telephone_number": "609-987-8900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.