NPIMap

Organization Active NPI

Dungarvin New Jersey, LLC-Dawson

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kendall Park, NJ
National Provider Identifier
1013363779
Registry record updated Apr 27, 2023
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
DUNGARVIN NEW JERSEY, LLC-DAWSON
Practice address
12 Dawson Rd
Kendall Park, NJ 08824
Phone
(732) 297-1532
NPI assigned
May 11, 2016
Organization subpart
Yes
Parent organization
DUNGARVIN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Mr. Lori Kress
Title
Ceo
Phone
(651) 699-0206

Specialties & licenses 1

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

Addresses

Primary practice location

12 Dawson Rd
Kendall Park, NJ 08824

Mailing address

1543 State Route 27
Suite 24
Somerset, NJ 08873-4015
Phone (732) 463-7227

Other identifiers 1

IdentifierTypeStateIssuer
0494275MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Dungarvin New Jersey LLC - Alberta40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1013363779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 STATE ROUTE 27",
            "address_2": "SUITE 24",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734015",
            "telephone_number": "732-463-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DAWSON RD",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "08824",
            "telephone_number": "732-297-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN NEW JERSEY, LLC-DAWSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2016-05-11",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-699-0206",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0494275",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendall Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.