Allendale Nursing Home, Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

0277983 Issued in NJ

Legal business name

ALLENDALE NURSING HOME, INC

Doing business as

Allendale Carlton Court

Practice address

85 Harreton Rd
Allendale, NJ 07401

Phone

(201) 825-0660

Fax

(201) 818-2031

NPI assigned

Feb 11, 2015

Last updated

Feb 11, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

ALLENDALE NURSING HOME, INCAs reported in NPPES

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

Authorized official

Name

Timothy Paul Giancarlo, DPM, LNHA

Title

President & Ceo

Phone

(201) 825-0660

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allendale Carlton Court Doing business as

Part of

Allendale Nursing Home Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Allendale Nursing Home Inc

  • Skilled Nursing Facility
  • Allendale, NJ
  • NPI 1881623908
  NPPES parent name

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1427449537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRETON RD",
            "city": "ALLENDALE",
            "state": "NJ",
            "postal_code": "07401",
            "telephone_number": "201-825-0660",
            "fax_number": "201-818-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HARRETON RD",
            "city": "ALLENDALE",
            "state": "NJ",
            "postal_code": "07401",
            "telephone_number": "201-825-0660",
            "fax_number": "201-818-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLENDALE NURSING HOME, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLENDALE NURSING HOME, INC",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "GIANCARLO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "201-825-0660",
        "authorized_official_credential": "DPM, LNHA"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NJ",
            "license": "0277983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0277983",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allendale Carlton Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allendale Nursing Home Inc
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• Gina Baltzer
• Jason Berenberg, LPC, LCADC
• Eugene James Berger, M.S.W.
• Janet Anne Bertelli, MSW, LCSW

• Custodial Care Facility in Allendale, NJ
• Providers in Allendale, NJ by specialty
• Custodial Care Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.