MEDICARE: RES-CARE NEW JERSEY, 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
1	315P00000X	Intellectual Disabilities Intermediate Care Facility		NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467784215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RES-CARE NEW JERSEY, INC.

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-5186
Country	:	US
Telephone Number	:	502-394-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 WOODPORT RD
Second Line	:
City	:	SPARTA
State	:	NJ
Zip	:	07871-2633
Country	:	US
Telephone Number	:	502-394-2100
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT
Name	:	MR. TIMOTHY TYLER WHOBREY
Credential	:
Telephone Number	:	502-630-7249

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	05/29/2020

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