Merion Gardens Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

75A001 Issued in NJ

Legal business name

MERION GARDENS ASSISTED LIVING, LLC

Practice address

315 Merion Ave
Carneys Point, NJ 08069-3402

Phone

(856) 299-0300

Fax

(856) 299-0190

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Bucolo, LNHA

Title

Administrator

Phone

(856) 299-0300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508996414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MERION AVE",
            "city": "CARNEYS POINT",
            "state": "NJ",
            "postal_code": "080693402",
            "telephone_number": "856-299-0300",
            "fax_number": "856-299-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MERION AVE",
            "city": "CARNEYS POINT",
            "state": "NJ",
            "postal_code": "080693402",
            "telephone_number": "856-299-0300",
            "fax_number": "856-299-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERION GARDENS ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCOLO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "856-299-0300",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "75A001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9046402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.