# CARE ONE AT WALL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Care One at Wall
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659370344
- **Authorized official:** MR. A. ALBERTO LUGO (EXECUTIVE VP & GENERAL COUNSEL)
- **Authorized official phone:** (201) 242-4000

## Contact information

- **Practice address:** 2621 HIGHWAY 138, WALL, NJ 07719
- **Practice address phone:** (732) 556-1060
- **Practice address fax:** (732) 556-1061
- **Mailing address:** 2621 HIGHWAY 138, WALL, NJ 07719
- **Mailing address phone:** (732) 556-1060
- **Mailing address fax:** (732) 556-1061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NJ | Yes |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 08/13/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 49018 | — | NJ |