Ca Fanwood LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

90A000 Issued in NJ

Legal business name

CA FANWOOD LLC

Doing business as

The Chelsea at Fanwood

Practice address

295 South Ave
Fanwood, NJ 07023-1357

Phone

(908) 654-5200

Fax

(908) 789-0451

NPI assigned

Mar 26, 2007

Last updated

Aug 22, 2020By 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

Ms. Deena B Schaffer

Title

Cfo

Phone

(908) 522-0808

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Chelsea at Fanwood Doing business as

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548387285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 UNION PL",
            "address_2": "2ND FLOOR",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013650",
            "telephone_number": "908-522-0808",
            "fax_number": "908-522-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 SOUTH AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231357",
            "telephone_number": "908-654-5200",
            "fax_number": "908-789-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CA FANWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "DEENA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "908-522-0808",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "90A000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7891903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Chelsea at Fanwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• Assisted Living Facility in New Jersey

• 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.