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NPI 1417544800 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Roselle Park, NJ
Provider details
- NPI number
- 1417544800
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Abayomi Okunnubi, Ceo(908) 917-1285
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
76 E Westfield Ave Apt 10
Roselle Park, NJ 07204-2237
Phone: (908) 917-1285
Street-level locationGet directions
Mailing address
76 E Westfield Ave Apt 10
Roselle Park, NJ 07204-2237
Registry dates
- Enumerated
- 2020-12-31
- Last updated
- 2020-12-31
- Certified
- 2020-12-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.