Provider Demographics
NPI:1568847853
Name:EDEN AUTISM SERVICES.
Entity Type:Organization
Organization Name:EDEN AUTISM SERVICES.
Other - Org Name:FARELL HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING DIRECTOR ADULT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DOUGLAS.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-987-0099
Mailing Address - Street 1:2 MERWICK ROAD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-987-0099
Mailing Address - Fax:
Practice Address - Street 1:105 MAPLESTREAM ROAD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520
Practice Address - Country:US
Practice Address - Phone:609-488-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDEN AUTISM SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities