NPI 1063244630

Beacon of Life North Nj LLC

Organisation PACE Provider Organization E Brunswick, NJ

Practice location

Address: 25 Kennedy Blvd, E Brunswick, NJ 08816-1259
Phone: (732) 806-3205
Mailing address: 106 W Moore Ave, Mooresville, NC 28115-3551

Authorised official

Name: Michael Czermak
Title: Chief Administrative Officer
Phone: (855) 801-2653

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in New Jersey →

Registry record

NPI: 1063244630
Entity type: Organization
NPI issued: 14 Aug 2024
Record last updated: 10 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.