MEDICARE: THE OPEN DOOR OF NEW JERSEY

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1750829701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OPEN DOOR OF NEW JERSEY

Provider Business Mailing Address
First Line	:	1658 LAKEWOOD RD
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-1280
Country	:	US
Telephone Number	:	732-408-5681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1658 LAKEWOOD RD
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-1280
Country	:	US
Telephone Number	:	732-408-5681
Fax Number	:

Authorized Official
Title or Position	:	QUALITY ASSURANCE
Name	:	NICOLE HALL
Credential	:
Telephone Number	:	732-408-5681

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	06/17/2026

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Directions to “THE OPEN DOOR OF NEW JERSEY ” Practice Location

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