CPL (Laurelton Village) LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

061532 Issued in NJ

Legal business name

CPL (LAURELTON VILLAGE) LLC

Doing business as

Laurelton Village Care Center

Practice address

475 Jack Martin Boulevard
Brick, NJ 08724-7732

Phone

(732) 458-6600

Fax

(732) 458-2674

NPI assigned

Jul 2, 2006

Organization subpart

Yes

Parent organization

NEW JERSEY CPL HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Carole M Scillia

Title

LLC Manager

Phone

(203) 608-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laurelton Village Care Center Doing business as

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1538198312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 PRESTON AVENUE",
            "address_2": "SUITE 270",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504851",
            "telephone_number": "203-608-6100",
            "fax_number": "203-639-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 JACK MARTIN BOULEVARD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-458-6600",
            "fax_number": "732-458-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPL (LAURELTON VILLAGE) LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW JERSEY CPL HOLDINGS LLC",
        "enumeration_date": "2006-07-02",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "SCILLIA",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LLC MANAGER",
        "authorized_official_telephone_number": "203-608-6100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "061532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4492706",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurelton Village Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Brick, NJ
• Providers in Brick, 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 15, 2011; 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.