The Residence at Forsgate

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

082462 Issued in NJ

Legal business name

THE RESIDENCE AT FORSGATE

Practice address

319 Forsgate Dr
Monroe Township, NJ 08831-1597

Phone

(732) 656-1000

Fax

(732) 656-0081

NPI assigned

Feb 8, 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

Mrs. Jennifer Rae Courlas, LNHA

Title

Executive Director

Phone

(732) 656-1000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649310376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 FORSGATE DR",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088311597",
            "telephone_number": "732-656-1000",
            "fax_number": "732-656-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 FORSGATE DR",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088311597",
            "telephone_number": "732-656-1000",
            "fax_number": "732-656-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RESIDENCE AT FORSGATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COURLAS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-656-1000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "082462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7721005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Monroe Township, NJ
• Providers in Monroe Township, 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.