Provider Demographics
NPI:1659597094
Name:ATRIA SENIOR LIVING
Entity Type:Organization
Organization Name:ATRIA SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONADIO
Authorized Official - Suffix:
Authorized Official - Credentials:CALA
Authorized Official - Phone:732-918-1960
Mailing Address - Street 1:44 PINE ST
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7710
Mailing Address - Country:US
Mailing Address - Phone:732-918-1960
Mailing Address - Fax:732-918-1952
Practice Address - Street 1:44 PINE STREET
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-918-1960
Practice Address - Fax:732-918-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ55A004251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7721013Medicaid