- Enrollment id
- O20040726000532
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1659370344
- Multiple npi flag
- N
- Ccn
- 315485
- Associate id
- 8224018544
- Organization name
- CARE ONE AT WALL, LLC
- Doing business as name
- CARE ONE AT WALL
- Incorporation date
- 1999-07-12
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CAREONE AT WALL
- Affiliation entity name
- CAREONE
- Affiliation entity id
- 109
- Address line 1
- 2621 HIGHWAY 138
- City
- WALL
- State
- NJ
- Zip code
- 077199660