MEDICARE: COMMUNITY OPTIONS ENTERPRISES, 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

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	:	1629652763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY OPTIONS ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	16 FARBER RD
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-5913
Country	:	US
Telephone Number	:	609-951-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 LAKE AVE
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-2919
Country	:	US
Telephone Number	:	609-951-9900
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. BELGICA VICTORIA CEDENO
Credential	:
Telephone Number	:	609-951-9900

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	07/20/2021

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