MEDICARE: THE OPEN DOOR OF NJ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251V00000X	Voluntary or Charitable Agency
3	253Z00000X	In Home Supportive Care Agency
4	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1063892982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OPEN DOOR OF NJ

Provider Business Mailing Address
First Line	:	1658 LAKEWOOD RD STE 12
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-1280
Country	:	US
Telephone Number	:	732-408-5681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1658 LAKEWOOD RD STE 12
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-1280
Country	:	US
Telephone Number	:	732-408-5681
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR/ OWNER
Name	:	ESTELLE PERRY
Credential	:
Telephone Number	:	732-408-5681

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	04/29/2021

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Directions to “THE OPEN DOOR OF NJ ” Practice Location

Language	Start Address	Practice Location

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