Provider Demographics
NPI:1114738630
Name:ROUSE, RAH-JOHN
Entity type:Individual
Prefix:
First Name:RAH-JOHN
Middle Name:
Last Name:ROUSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1489
Mailing Address - Country:US
Mailing Address - Phone:551-214-7376
Mailing Address - Fax:908-352-1036
Practice Address - Street 1:850 WOODRUFF LN
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2022
Practice Address - Country:US
Practice Address - Phone:908-352-0850
Practice Address - Fax:908-352-1036
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)