Provider Demographics
NPI:1144714080
Name:VILLAGE DRIVE HEALTHCARE URBAN RENEWAL LLC
Entity type:Organization
Organization Name:VILLAGE DRIVE HEALTHCARE URBAN RENEWAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
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 1:1125 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-1513
Mailing Address - Country:US
Mailing Address - Phone:856-469-8192
Mailing Address - Fax:
Practice Address - Street 1:1125 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-1581
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:2018-06-14
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care