Provider Demographics
NPI:1689495525
Name:JESPY HOUSE
Entity type:Organization
Organization Name:JESPY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTTENSTREICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-762-2715
Mailing Address - Street 1:76 S ORANGE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1923
Mailing Address - Country:US
Mailing Address - Phone:973-762-8835
Mailing Address - Fax:
Practice Address - Street 1:76 S ORANGE AVE STE LL5
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1937
Practice Address - Country:US
Practice Address - Phone:973-762-8835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services