Provider Demographics
NPI:1770182792
Name:NOBLE SENIOR LIVING AT RIO GRANDE LLC
Entity Type:Organization
Organization Name:NOBLE SENIOR LIVING AT RIO GRANDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BARILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-403-3151
Mailing Address - Street 1:137 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1923
Mailing Address - Country:US
Mailing Address - Phone:732-403-3151
Mailing Address - Fax:
Practice Address - Street 1:1042 NJ-47
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242
Practice Address - Country:US
Practice Address - Phone:732-403-3151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness