NPIMap

Organization Active NPI

Eden Autism Services.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Lawrenceville, NJ
National Provider Identifier
1043695349
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
EDEN AUTISM SERVICES.
Practice address
11132 E Run Dr
Lawrenceville, NJ 08648-1234
Phone
(609) 799-0928
NPI assigned
Jul 28, 2015
Organization subpart
Yes
Parent organization
EDEN AUTISM SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jamie K. Douglas.
Title
Managing Director Adult Services
Phone
(609) 987-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

11132 E Run Dr
Lawrenceville, NJ 08648-1234

Mailing address

2 Merwick Road
Princeton, NJ 08540
Phone (609) 987-0099

Other names 1

  • Avalon Run Other name

National Provider Directory

National Provider Directory
Tax ID family
Eden Institute46 organizations share this tax ID, including this one
Part of
Eden Institute

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1043695349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERWICK ROAD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-987-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11132 E RUN DR",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086481234",
            "telephone_number": "609-799-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN AUTISM SERVICES.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDEN AUTISM SERVICES",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS.",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "MANAGING DIRECTOR ADULT SERVICES",
        "authorized_official_telephone_number": "609-987-0099"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Run",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.