Provider Demographics
NPI:1417370354
Name:THE ROSE HOUSE, A NEW JERSEY NON-PROFIT CORPORATION
Entity Type:Organization
Organization Name:THE ROSE HOUSE, A NEW JERSEY NON-PROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-984-0006
Mailing Address - Street 1:51 GIBRALTAR DR
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1254
Mailing Address - Country:US
Mailing Address - Phone:973-984-0006
Mailing Address - Fax:973-998-0002
Practice Address - Street 1:51 GIBRALTAR DR
Practice Address - Street 2:SUITE 2C
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-1254
Practice Address - Country:US
Practice Address - Phone:973-984-0006
Practice Address - Fax:973-998-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health