Organization Active NPI

Assisted Living of Forked River, Inc.

  • Assisted Living Facility
  • Phillipsburg, NJ
National Provider Identifier
1659421162
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
65A006 Issued in NJ
Legal business name
ASSISTED LIVING OF FORKED RIVER, INC.
Doing business as
Spring Oak Assisted Living of Forked River
Practice address
1503 S Main St
Phillipsburg, NJ 08865-3736
Phone
(908) 859-8500
Fax
(908) 859-5151
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Gail Rader, RN,CALA
Title
Management Agent
Phone
(908) 859-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 65A006 NJ Primary

Addresses

Primary practice location

1503 S Main St
Phillipsburg, NJ 08865-3736

Mailing address

1503 S Main St
Phillipsburg, NJ 08865-3736
Phone (908) 859-8500

Other identifiers 1

IdentifierTypeStateIssuer
8131309MedicaidNJ

Other names 1

  • Spring Oak Assisted Living of Forked River Doing business as

National Provider Directory

National Provider Directory

Locations

601 US Highway 9
Lanoka Harbor, NJ 08734
Phone (609) 242-2261

1503 S Main St
Phillipsburg, NJ 08865
Phone (908) 859-8500

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659421162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 S MAIN ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088653736",
            "telephone_number": "908-859-8500",
            "fax_number": "908-859-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S MAIN ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088653736",
            "telephone_number": "908-859-8500",
            "fax_number": "908-859-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSISTED LIVING OF FORKED RIVER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "MANAGEMENT AGENT",
        "authorized_official_telephone_number": "908-859-8500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN,CALA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "65A006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8131309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Oak Assisted Living of Forked River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phillipsburg, NJ

Sources for this page

  • 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.