Provider Demographics
NPI:1306342373
Name:REFOCUS
Entity type:Organization
Organization Name:REFOCUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:GOODMAN
Authorized Official - Last Name:EMMERICH
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MS
Authorized Official - Phone:732-343-1478
Mailing Address - Street 1:PO BOX 7229
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7229
Mailing Address - Country:US
Mailing Address - Phone:732-343-1478
Mailing Address - Fax:
Practice Address - Street 1:200 ROUND HILL DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8210
Practice Address - Country:US
Practice Address - Phone:732-343-1478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities