Healthcare Provider Details

I. General information

NPI: 1538513908
Provider Name (Legal Business Name): COMMUNITY OPTIONS ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 ALEXANDER RD
PRINCETON NJ
08540-6331
US

IV. Provider business mailing address

16 FARBER RD
PRINCETON NJ
08540-5913
US

V. Phone/Fax

Practice location:
  • Phone: 609-514-9494
  • Fax: 609-243-0045
Mailing address:
  • Phone: 609-951-9900
  • Fax: 609-951-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT P STACK
Title or Position: PRESIDENT & CEO
Credential: MA
Phone: 609-951-9900