NPIMap

Organization Active NPI

SHP V Roseland, LLC

  • Assisted Living Facility
  • Roseland, NJ
National Provider Identifier
1477094472
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
07015 Issued in NJ
Legal business name
SHP V ROSELAND, LLC
Practice address
345 Eagle Rock Avenue
Roseland, NJ 07068
Phone
(973) 618-1888
Fax
(973) 618-0888
NPI assigned
Mar 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Authorized official

Name
Mr. Robert Jason Fiorese, AO
Title
Executive Director
Phone
(973) 618-1888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 07015 NJ Primary
Alzheimer Center (Dementia Center) 311500000X

Addresses

Primary practice location

345 Eagle Rock Avenue
Roseland, NJ 07068

Mailing address

P.O. Box 70469
Louisville, KY 40270
Phone (973) 618-1888

Other identifiers 1

IdentifierTypeStateIssuer
0593877MedicaidNJ

Other names 1

  • Arbor Terrace Roseland Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1477094472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 70469",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40270",
            "telephone_number": "973-618-1888",
            "fax_number": "973-618-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 EAGLE ROCK AVENUE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "07068",
            "telephone_number": "973-618-1888",
            "fax_number": "973-618-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHP V ROSELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "FIORESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-618-1888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AO"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "07015",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0593877",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Terrace Roseland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arbor Terrace Roseland",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Arbor Terrace Roseland",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.