Healthcare Provider Details

I. General information

NPI: 1194640532
Provider Name (Legal Business Name): RENEW360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 ROUTE 37 W
TOMS RIVER NJ
08755
US

IV. Provider business mailing address

432 LAKEHURST RD STE 2
TOMS RIVER NJ
08755-7333
US

V. Phone/Fax

Practice location:
  • Phone: 732-234-0058
  • Fax: 848-317-8309
Mailing address:
  • Phone: 732-234-0058
  • Fax: 848-317-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBERT STONE
Title or Position: GENERAL MANAGER
Credential:
Phone: 732-234-0058