Organization Active NPI

Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Long Branch, NJ
National Provider Identifier
1003320409
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PENNREACH
Practice address
163 Garrett Dr
Long Branch, NJ 07740-5587
Phone
(732) 963-4523
Fax
(609) 259-4120
NPI assigned
Nov 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pauline Bailo
Title
Director
Phone
(215) 475-2401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

163 Garrett Dr
Long Branch, NJ 07740-5587

Mailing address

18 S Main St
Allentown, NJ 08501-1610
Phone (732) 963-4523

National Provider Directory

National Provider Directory
Tax ID family
Pennreach87 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pennreach/r4/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1003320409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 S MAIN ST",
            "city": "ALLENTOWN",
            "state": "NJ",
            "postal_code": "085011610",
            "telephone_number": "732-963-4523",
            "fax_number": "609-259-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 GARRETT DR",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405587",
            "telephone_number": "732-963-4523",
            "fax_number": "609-259-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "BAILO",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-475-2401"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.