Basic Information
| Provider Information | |||||||||
| NPI: | 1134246879 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARE PLUS NJ, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 610 VALLEY HEALTH PLZ | ||||||||
| Address2: | |||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012658200 | ||||||||
| FaxNumber: | 2012650366 | ||||||||
| Practice Location | |||||||||
| Address1: | 17-07 ROMAINE ST | ||||||||
| Address2: | |||||||||
| City: | FAIR LAWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074102150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017972660 | ||||||||
| FaxNumber: | 2017975025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 01/30/2012 | ||||||||
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| AuthorizedOfficialLastName: | KRIEGER | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2019865072 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 0020265 | 05 | NJ | MEDICAID | 0020176 | 05 | NJ | MEDICAID |