PRIME CARE ONE LLC NPI 1831243120

NPI Information

  • NPI: 1831243120
  • Provider Name: PRIME CARE ONE, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • :
  • CLIA Number: 31D2194614
  • Address: 1350 US HIGHWAY 22
    MOUNTAINSIDE, NJ
    ZIP 07092
  • Phone: (908) 654-4460

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NPI Details

PRIME CARE ONE, LLC is an assisted living facility in Mountainside, NJ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PRIME CARE ONE, LLC NPI is 1831243120. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1350 US HIGHWAY 22
MOUNTAINSIDE, NJ
ZIP 07092-614
Phone: (908) 654-4460

The provider's authorized official is Tony J. Harris .
The authorized official title is Senior Reimbursement Manager and has the following contact phone number (703) 854-0830.

The CLIA number assigned to this NPI record is 31D2194614 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2007 and was last updated on 1/22/2025.

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
1310400000XAssisted Living Facility90122NEW JERSEYYes

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
18353808MEDICAIDNEW 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: 11/21/2025

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