Provider Demographics
NPI:1336647361
Name:EDEN AUTISM
Entity Type:Organization
Organization Name:EDEN AUTISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EHR TRAINER (NOW EHR MGR)
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-608-8531
Mailing Address - Street 1:2 MERWICK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5730
Mailing Address - Country:US
Mailing Address - Phone:609-987-0099
Mailing Address - Fax:609-987-0243
Practice Address - Street 1:2 MERWICK RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5730
Practice Address - Country:US
Practice Address - Phone:609-987-0099
Practice Address - Fax:609-987-0243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child