OrganizationActive
11 History Lane Operating Company, LLC
NPI 1932108693 · Skilled Nursing Facility · Jackson, NJ
Provider details
- NPI number
- 1932108693
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- A. Lugo, Executive Vp & General Counsel
- License
- 0088447 (NJ)
Practice location
11 History Lane
Jackson, NJ 08527
Phone: (732) 367-6600
Fax: (732) 905-9641
Mailing address
11 History Lane
Jackson, NJ 08527
Registry dates
- Enumerated
- 2005-07-15
- Last updated
- 2015-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.