Healthcare Provider Details

I. General information

NPI: 1063966943
Provider Name (Legal Business Name): RUTGERS CENTER FOR ADULT AUTISM SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUDLEY RD
NEW BRUNSWICK NJ
08901-8523
US

IV. Provider business mailing address

100 DUDLEY RD
NEW BRUNSWICK NJ
08901-8523
US

V. Phone/Fax

Practice location:
  • Phone: 848-445-3973
  • Fax: 732-932-3269
Mailing address:
  • Phone: 848-445-3973
  • Fax: 732-932-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER MANENTE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD, BCBA
Phone: 848-445-3973