Tag Senior Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

62104 Issued in NJ

Legal business name

TAG SENIOR CARE LLC

Doing business as

Clover Rest Home

Practice address

28 Washington St
Columbia, NJ 07832-2324

Phone

(908) 496-4307

NPI assigned

Apr 6, 2009

Last updated

Apr 6, 2009By 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

Alvan Small

Title

Administrator

Phone

(732) 841-5483

Specialties & licenses 1

Addresses

Other names 1

• Clover Rest Home Doing business as

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1457593444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WASHINGTON ST",
            "city": "COLUMBIA",
            "state": "NJ",
            "postal_code": "078322324",
            "telephone_number": "908-496-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WASHINGTON ST",
            "city": "COLUMBIA",
            "state": "NJ",
            "postal_code": "078322324",
            "telephone_number": "908-496-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAG SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "ALVAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-841-5483"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "62104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clover Rest Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rem New Jersey, Inc.
• Rha Health Services NJ LLC
• Sam's Hope, Incorporated
• Kristen Ann Schiller
• Tammy A. Strunk, COTA
• The Arc, Warren County Chapter
• The Arc, Warren County Chapter, Inc.
• Total Family Care, LLC.
• Brittany Trifari
• Donald Tsay, M.D.

• Skilled Nursing Facility in Columbia, NJ
• Providers in Columbia, 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 Apr 6, 2009; 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.