Provider Demographics
NPI:1417480971
Name:NUBIAN KEEPERS INITIATIVE, INC
Entity Type:Organization
Organization Name:NUBIAN KEEPERS INITIATIVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-600-1334
Mailing Address - Street 1:PO BOX 493
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-0493
Mailing Address - Country:US
Mailing Address - Phone:732-600-1334
Mailing Address - Fax:
Practice Address - Street 1:175 MUNN AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2745
Practice Address - Country:US
Practice Address - Phone:732-600-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility