Provider Demographics
NPI:1861273633
Name:REGAL GROUP HOMES
Entity type:Organization
Organization Name:REGAL GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:732-742-4875
Mailing Address - Street 1:150 MAPLE AVE # 115
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-3407
Mailing Address - Country:US
Mailing Address - Phone:732-742-4875
Mailing Address - Fax:844-663-2727
Practice Address - Street 1:952 TERRACE BLVD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1902
Practice Address - Country:US
Practice Address - Phone:732-742-4875
Practice Address - Fax:844-663-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities