Provider Demographics
NPI:1982438339
Name:VISION RIVERSIDE ASSISTED LIVING LLC
Entity type:Organization
Organization Name:VISION RIVERSIDE ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENGERLE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:908-872-1237
Mailing Address - Street 1:3996 COUNTY ROAD 516 STE 106
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-7081
Mailing Address - Country:US
Mailing Address - Phone:908-872-1237
Mailing Address - Fax:
Practice Address - Street 1:105 OLD MATAWAN RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1457
Practice Address - Country:US
Practice Address - Phone:908-872-1237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility