Healthcare Provider Details

I. General information

NPI: 1063259075
Provider Name (Legal Business Name): REM NEW JERSEY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 CONNECTICUT DR STE C
BURLINGTON NJ
08016-4180
US

IV. Provider business mailing address

80 COTTONTAIL LN STE 330
SOMERSET NJ
08873-1100
US

V. Phone/Fax

Practice location:
  • Phone: 732-627-9890
  • Fax:
Mailing address:
  • Phone: 732-627-9890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RYAN JAMES LOVELADY
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 862-284-4565