Pennreach

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PENNREACH

Practice address

111 Truman Square
Apt 1212
Edison, NJ 08817-0850

Phone

(215) 409-5519

NPI assigned

Jul 23, 2020

Last updated

Jul 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krystal Odell

Title

Ceo

Phone

(215) 409-5519

Specialties & licenses 1

Addresses

Tax ID family

Pennreach87 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

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

• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Long Branch, NJ
  • NPI 1003320409
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Long Branch, NJ
  • NPI 1013421411
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Allentown, NJ
  • NPI 1043724545
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jersey City, NJ
  • NPI 1043799893
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fort Lee, NJ
  • NPI 1053966986
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Edison, NJ
  • NPI 1063030948
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Woodbridge, NJ
  • NPI 1063066470
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Aberdeen, NJ
  • NPI 1063991768
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fort Lee, NJ
  • NPI 1083269211
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Allentown, NJ
  • NPI 1093666729
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Metuchen, NJ
  • NPI 1104780303
  NPD tax ID
• Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bordentown, NJ
  • NPI 1124532692
  NPD tax ID

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1003425398",
    "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": "215-409-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TRUMAN SQUARE",
            "address_2": "APT 1212",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088170850",
            "telephone_number": "215-409-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-409-5519"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Pedersen, PA-C
• Deepa Pednekar
• Haritha Pendli
• Peng Lu LLC
• James Penn, M.D.
• Pennreach
• Pennreach
• Pennreach
• Pennreach
• Pennreach

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Edison, NJ
• Providers in Edison, NJ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.