=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922936178
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIOS ENTERPRISE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2026
-----------------------------------------------------
Last Update Date | 05/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 E TAUNTON RD STE 559
-----------------------------------------------------
City | BERLIN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08009-2615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-966-2503
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 108 HARMONY CIRCLE RD
-----------------------------------------------------
City | SICKLERVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08081-5637
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-966-2503
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ZACHARY J RIOS
-----------------------------------------------------
Credential | MSN, APRN, AGNP-C
-----------------------------------------------------
Telephone | 732-966-2503
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------