Healthcare Provider Details

I. General information

NPI: 1316747579
Provider Name (Legal Business Name): OUR HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ALLETTA ST
PLAINFIELD NJ
07060-2703
US

IV. Provider business mailing address

76 FLORAL AVE
NEW PROVIDENCE NJ
07974-1511
US

V. Phone/Fax

Practice location:
  • Phone: 908-464-8008
  • Fax:
Mailing address:
  • Phone: 908-377-7696
  • Fax:

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0479179
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: NATALIE TORTORELLO
Title or Position: COO
Credential:
Phone: 908-464-8008