MEDICARE: AVENUES RECOVERY CENTER OF CENTRAL JERSEY, LLC

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1144799859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVENUES RECOVERY CENTER OF CENTRAL JERSEY, LLC

Provider Business Mailing Address
First Line	:	211 BOULEVARD OF THE AMERICAS
Second Line	:	SUITE 503
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-6924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 SCOTCH RD STE C
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-2529
Country	:	US
Telephone Number	:	609-583-4915
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HUDI ALTER
Credential	:
Telephone Number	:	732-307-8000

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	03/30/2023

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