Provider Demographics
| NPI: | 1659754224 |
|---|---|
| Name: | EIHAB HUMAN SERVICES NEW JERSEY, INC. |
| Entity type: | Organization |
| Organization Name: | EIHAB HUMAN SERVICES NEW JERSEY, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO/EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | AHMED |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HEGAZY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 718-276-6101 |
| Mailing Address - Street 1: | 16818 S CONDUIT AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | JAMAICA |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 11434-4806 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4 TOBY TER |
| Practice Address - Street 2: | |
| Practice Address - City: | MONROE TOWNSHIP |
| Practice Address - State: | NJ |
| Practice Address - Zip Code: | 08831-8564 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 718-276-6101 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-07-01 |
| Last Update Date: | 2015-07-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 251B00000X | Agencies | Case Management | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | |
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
