Juniper Village at Williamstown LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

35A004 Issued in NJ

Legal business name

JUNIPER VILLAGE AT WILLIAMSTOWN LLC

Doing business as

Juniper Village at Williamstown -Wellspring Program

Practice address

1648 S Black Horse Pike
Williamstown, NJ 08094-9247

Phone

(856) 740-4444

Fax

(856) 740-4445

NPI assigned

Mar 28, 2007

Last updated

Nov 6, 2014By 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

Linda C. Donato

Title

Secretaty

Phone

(973) 945-3526

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Juniper Village at Williamstown -Wellspring Program Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Juniper Village at Williamstown2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Juniper Village at Williamstown, LLC

  dba Juniper Village at Williamstown

  • Assisted Living Facility
  • Williamstown, NJ
  • NPI 1124146030
  NPD tax ID

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1891814406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949247",
            "telephone_number": "856-740-4444",
            "fax_number": "856-740-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949247",
            "telephone_number": "856-740-4444",
            "fax_number": "856-740-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIPER VILLAGE AT WILLIAMSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "DONATO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "SECRETATY",
        "authorized_official_telephone_number": "973-945-3526"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "35A004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8098654",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juniper Village at Williamstown -Wellspring Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey R Mack DMD PA
• Patricia Jones-Pope, LPC
• Stacey Jones, OT
• Cathleen M Jordan
• Michelle Lynn Juckett, APN
• Juniper Village at Williamstown, LLC (Juniper Village at Williamstown)
• Rajeswari Kanthan, MD
• Roman Karpiel
• Jeffrey Kehl, PHARMD
• Shannon Kelly, M.S., BCBA

• Assisted Living Facility in Williamstown, NJ
• Providers in Williamstown, 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 Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.