Ti Healthcare I LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

062103 Issued in NJ

Legal business name

TI HEALTHCARE I LLC

Doing business as

Forest Manor Health Care Center

Practice address

145 State Park Road
Blairstown, NJ 07825-4206

Phone

(908) 459-4128

Fax

(908) 459-4513

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

William A Nicholson

Title

Manager

Phone

(908) 459-4128

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Forest Manor Health Care Center Doing business as

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376664177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "HOPE",
            "state": "NJ",
            "postal_code": "078440283",
            "telephone_number": "908-459-4128",
            "fax_number": "908-459-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 STATE PARK ROAD",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078254206",
            "telephone_number": "908-459-4128",
            "fax_number": "908-459-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TI HEALTHCARE I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "908-459-4128"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "062103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9032401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Manor Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stillwater Health and Wellness LLC
• David E Stoner, RPH
• Brad David Strauss, ATC
• Jessi Sugar, PHARMD
• John C Thomas, RPH.
• Mostafa Wali, PHARM.D.
• Elias Wood
• Shelly Wong Woodward, M.D.
• Lara Beth Yeager, LAC
• George B. Young, D.D.S.

• Skilled Nursing Facility in Blairstown, NJ
• Providers in Blairstown, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.