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General NPI Number Information
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NPI Number | 1770182792
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Entity Type | Organization
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Legal Business Name | NOBLE SENIOR LIVING AT RIO GRANDE LLC
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 1042 NJ-47
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City | RIO GRANDE
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State | NJ
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Zip | 08242
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Country | US
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Telephone | 732-403-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 137 BROAD ST
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City | RED BANK
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State | NJ
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Zip | 07701-1923
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Country | US
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Telephone | 732-403-3151
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DREW BARILE
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Credential |
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Telephone | 732-403-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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