Jersey Innovative Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

XXX Issued in NJ

Legal business name

JERSEY INNOVATIVE SERVICES LLC

Practice address

2360 Lakewood Rd
Suite 3 #256
Toms River, NJ 08755-1929

Phone

(732) 614-6145

Fax

(732) 612-1162

NPI assigned

Jan 30, 2017

Organization subpart

No

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

Authorized official

Name

Erika Hollander

Title

Manager

Phone

(732) 614-6145

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1043757990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 LAKEWOOD RD",
            "address_2": "SUITE 3 #256",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551929",
            "telephone_number": "732-614-6145",
            "fax_number": "732-612-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 LAKEWOOD RD",
            "address_2": "SUITE 3 #256",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551929",
            "telephone_number": "732-614-6145",
            "fax_number": "732-612-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY INNOVATIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "HOLLANDER",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-614-6145"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "XXX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169994",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.