Healthcare Provider Details

I. General information

NPI: 1285556696
Provider Name (Legal Business Name): VISION RIVERSIDE ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 OLD MATAWAN ROAD
OLD BRIDGE NJ
08857
US

IV. Provider business mailing address

105 OLD MATAWAN ROAD
OLD BRIDGE NJ
08857
US

V. Phone/Fax

Practice location:
  • Phone: 732-440-7736
  • Fax: 732-385-8873
Mailing address:
  • Phone: 732-440-7736
  • Fax: 732-385-8873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHIPRA JAIN
Title or Position: EXECUTIVE DIRECTOR
Credential: CALA
Phone: 732-440-7736