Healthcare Provider Details

I. General information

NPI: 1043692668
Provider Name (Legal Business Name): NATIONAL INSTITUTE FOR PEOPLE WITH DISABILITIES OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 OLD HOOK RD APT 1
WESTWOOD NJ
07675-2287
US

IV. Provider business mailing address

PO BOX 301
ORADELL NJ
07649-0301
US

V. Phone/Fax

Practice location:
  • Phone: 201-263-9365
  • Fax: 201-497-5549
Mailing address:
  • Phone: 201-750-0509
  • Fax: 845-358-6119

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: RALPH COLOMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 201-750-0509