Healthcare Provider Details

I. General information

NPI: 1861273633
Provider Name (Legal Business Name): REGAL GROUP HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

952 TERRACE BLVD
EWING NJ
08618-1902
US

IV. Provider business mailing address

150 MAPLE AVE # 115
SOUTH PLAINFIELD NJ
07080-3407
US

V. Phone/Fax

Practice location:
  • Phone: 732-742-4875
  • Fax: 844-663-2727
Mailing address:
  • Phone: 732-742-4875
  • Fax: 844-663-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE L SIMS
Title or Position: EXECUTIVE DIRECTOR
Credential: BS
Phone: 732-742-4875