Healthcare Provider Details

I. General information

NPI: 1528448719
Provider Name (Legal Business Name): NEW JERSEY INSTITUTE FOR DISABILITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 OLD FREEHOLD RD
TOMS RIVER NJ
08753-5354
US

IV. Provider business mailing address

10A OAK DR ROOSEVELT PARK
EDISON NJ
08837-2313
US

V. Phone/Fax

Practice location:
  • Phone: 732-549-6187
  • Fax: 732-590-2431
Mailing address:
  • Phone: 732-549-6187
  • Fax: 732-590-2431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. ROBERT FERRARA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 732-549-6187