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General NPI Number Information
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NPI Number | 1033624697
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Entity Type | Organization
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Legal Business Name | JEWISH SERVICE FOR THE DEVELOPMENTALLY DISABLED OF METROWEST, INC.
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 141 BURNETT AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2906
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Country | US
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Telephone | 973-272-7141
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Fax |
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Provider Business Mailing Address
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Address Line | 310 EISENHOWER PKWY
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1708
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Country | US
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Telephone |
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Fax | 973-993-1509
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LINDA RAE PRESS
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Credential |
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Telephone | 973-272-7141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | SA544
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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