HBLR/Randolph Operating, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

60A012 Issued in NJ

Legal business name

HBLR/RANDOLPH OPERATING, LLC

Doing business as

Sunrise Assisted Living of Randolph

Practice address

648 RT. 10 West
Randolph, NJ 07869

Phone

(973) 328-1922

NPI assigned

Jan 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joann Ryan, ALA

Title

Executive Director

Phone

(973) 328-1922

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunrise Assisted Living of Randolph Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1174677538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 RT. WEST",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-328-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 RT. 10 WEST",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-328-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HBLR/RANDOLPH OPERATING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-328-1922",
        "authorized_official_credential": "ALA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "60A012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133744",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Assisted Living of Randolph",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.