Provider Demographics
NPI:1700620176
Name:RICHARDSMINDREHAB
Entity type:Organization
Organization Name:RICHARDSMINDREHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOFFE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-234-5717
Mailing Address - Street 1:3501 PEPPERBUSH CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1077
Mailing Address - Country:US
Mailing Address - Phone:570-234-5717
Mailing Address - Fax:
Practice Address - Street 1:3501 PEPPERBUSH CT
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1077
Practice Address - Country:US
Practice Address - Phone:570-234-5717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty