# EDEN AUTISM SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EDEN AUTISM SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184372625
- **Legal business name:** EDEN AUTISM SERVICES
- **Authorized official:** BETH LO (ASST. DIRECTOR OF MEDICAID & EHR)
- **Authorized official phone:** (609) 608-8531

## Contact information

- **Practice address:** 313 OAK LN, WEST WINDSOR, NJ 08550-3611
- **Practice address phone:** (609) 987-0099
- **Practice address fax:** (609) 987-0243
- **Mailing address:** 2 MERRICK ROAD, PRINCETON, NJ 08540-5730
- **Mailing address phone:** (609) 987-0099
- **Mailing address fax:** (609) 987-0243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 05/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0476536 | — | NJ |