Organization Active NPI

Juniper Village at Williamstown, LLC

  • Assisted Living Facility
  • Williamstown, NJ
National Provider Identifier
1124146030
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
35A005 Issued in NJ
Legal business name
JUNIPER VILLAGE AT WILLIAMSTOWN, LLC
Practice address
1640 S Black Horse Pike
Williamstown, NJ 08094-9247
Phone
(856) 740-4444
Fax
(856) 740-4445
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Linda C. Donato
Title
Secretaty
Phone
(973) 945-3526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 35A005 NJ Primary

Addresses

Primary practice location

1640 S Black Horse Pike
Williamstown, NJ 08094-9247

Mailing address

1640 S Black Horse Pike
Williamstown, NJ 08094-9247
Phone (856) 740-4444

Other identifiers 1

IdentifierTypeStateIssuer
8098662MedicaidNJ

Other names 1

  • Juniper Village at Williamstown Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1023243Juniper Village at Williamstown1640 South Black Horse Pike, Williamstown, NJ 08094Certificate of waiverDec 25, 2026

National Provider Directory

National Provider Directory
Tax ID family
Juniper Village at Williamstown2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1124146030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949247",
            "telephone_number": "856-740-4444",
            "fax_number": "856-740-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949247",
            "telephone_number": "856-740-4444",
            "fax_number": "856-740-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIPER VILLAGE AT WILLIAMSTOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "DONATO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "SECRETATY",
        "authorized_official_telephone_number": "973-945-3526"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "35A005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8098662",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juniper Village at Williamstown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.