RIVERSIDE MANOR ADULT DAY HEALTH CARE CENTER L.L.C. NPI 1053438002

NPI Information

NPI: 1053438002
Provider Name: RIVERSIDE MANOR ADULT DAY HEALTH CARE CENTER L.L.C.
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 31D1029361

Address:
699 CROSS ST
LAKEWOOD, NJ
ZIP 08701
Phone: (732) 370-9400
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RIVERSIDE MANOR ADULT DAY HEALTH CARE CENTER L.L.C. is an adult day care clinic center in Lakewood, NJ. RIVERSIDE MANOR ADULT DAY HEALTH CARE CENTER L.L.C. NPI is 1053438002. The provider is registered as an organization entity type.

The provider's business location address is:

699 CROSS ST
LAKEWOOD, NJ
ZIP 08701-610
Phone: (732) 370-9400

The provider's authorized official is David Miller .
The authorized official title is Manager and has the following contact phone number (732) 370-9400.

The CLIA number assigned to this NPI record is 31D1029361 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care	4019N9	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8723303	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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