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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
1251C00000XDevelopmentally Disabled Services Day Training Agency
2251C00000XDevelopmentally Disabled Services Day Training AgencyNJ

General Provider Information

NPI Number : 1417339052
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 : 732-805-1912
Fax Number : 732-805-3088
Provider Business Practice Location Address
First Line : 60 SADDLE RIVER AVE
Second Line :
City : SOUTH HACKENSACK
State : NJ
Zip : 07606-1908
Country : US
Telephone Number : 201-880-6622
Fax Number : 201-880-6623
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JENNIFER RECTOR
Credential :
Telephone Number : 732-805-1912
Provider Enumeration Date : 06/19/2015
Last Update Date : 07/21/2022

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

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