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NPI Code Detail

MEDICARE: EVERAS COMMUNITY SERVICES, INC.

MEDICARE: EVERAS COMMUNITY SERVICES, INC.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityGH664ANJ

General Provider Information

NPI Number : 1083141790
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVERAS COMMUNITY SERVICES, INC.
Provider Business Mailing Address
First Line : 24 WORLDS FAIR DR STE K
Second Line :
City : SOMERSET
State : NJ
Zip : 08873-1349
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 222 W END AVE
Second Line :
City : NORTH PLAINFIELD
State : NJ
Zip : 07060-4527
Country : US
Telephone Number : 908-941-4378
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JENNIFER RECTOR
Credential :
Telephone Number : 732-805-1912
Provider Enumeration Date : 05/12/2017
Last Update Date : 05/12/2017

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Directions to “EVERAS COMMUNITY SERVICES, INC. ” Practice Location

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