Shady Lane Nursing Home

LBN: County Of Gloucester
Shady Lane Nursing Home is an health care organization with primary practice located at 256 County House Rd , Clarksboro NJ 08020-1395. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. County Of Gloucester can be contacted via phone (856) 423-5318, or through Scaffidi, Pete via phone (856) 423-5318.

Contact Information

Primary practice address
256 County House Rd Clarksboro NJ 08020-1395
Phone: (856) 423-5318
Fax: (856) 423-3634
Website:
Map and Directions
Authorized official contact:
Name: Scaffidi, Pete
Phone: (856) 423-5318

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 060805 New Jersey

Profile Details

NPI number 1447384680
LBN Legal business name County Of Gloucester
DBA Doing business as Shady Lane Nursing Home
Authorized official Scaffidi, Pete
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2007
Last updated Jun 24th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447384680 NPPES
New Jersey MEDICAID 4478703

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