SL Millville, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

90108 Issued in NJ

Legal business name

SL MILLVILLE, LLC

Practice address

1719 W Main St
Millville, NJ 08332-4632

Phone

(856) 825-4002

Fax

(856) 327-2037

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Rita Rivera-Worley

Title

Executive Director

Phone

(856) 825-4002

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maurice House Doing business as

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1679964712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 W MAIN ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083324632",
            "telephone_number": "856-825-4002",
            "fax_number": "856-327-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 W MAIN ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083324632",
            "telephone_number": "856-825-4002",
            "fax_number": "856-327-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SL MILLVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "RIVERA-WORLEY",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-825-4002"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "90108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0457761",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maurice House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Simkins
• Sara L Simmons
• Benita Simpson, COTA
• Paul I Singh, RPH
• Gary Joseph Skroski, RPH
• SLP Services of South Jersey LLC
• Heather Smith
• SN Supreme LLC
• Charles Sonaliya, MD
• South Jersey Cardiology, P.C.

• Assisted Living Facility in Millville, NJ
• Providers in Millville, 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 Jun 12, 2015; 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.