Healthcare Provider Details

I. General information

NPI: 1255711156
Provider Name (Legal Business Name): REM NEW JERSEY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 BUTTONWOOD DR
PILESGROVE NJ
08098-2437
US

IV. Provider business mailing address

80 COTTONTAIL LN SUITE 330
SOMERSET NJ
08873-1100
US

V. Phone/Fax

Practice location:
  • Phone: 732-627-9890
  • Fax:
Mailing address:
  • Phone: 732-627-9890
  • Fax: 732-563-6780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRETT IAN COHEN
Title or Position: COO
Credential:
Phone: 800-388-5150