Active NPI
Pennreach
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Fort Lee, NJ
National Provider Identifier
1053966986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- PENNREACH
- Practice address
- 69 Main St Apt 812
Fort Lee, NJ 07024-6909 - Phone
- (215) 409-5519
- NPI assigned
- Aug 7, 2019
- Last updated
- Aug 7, 2019
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | NU | Primary |
Addresses
Primary practice location
69 Main St Apt 812
Fort Lee, NJ 07024-6909
Mailing address
18 S Main St
Allentown, NJ 08501-1610
National Provider Directory
National Provider Directory- Tax ID family
- Pennreach
Organizations with this tax ID in the same state 17
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Long Branch, NJ
- NPI 1003320409
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Edison, NJ
- NPI 1003425398
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Long Branch, NJ
- NPI 1013421411
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Allentown, NJ
- NPI 1043724545
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jersey City, NJ
- NPI 1043799893
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Edison, NJ
- NPI 1063030948
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Woodbridge, NJ
- NPI 1063066470
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Aberdeen, NJ
- NPI 1063991768
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Fort Lee, NJ
- NPI 1083269211
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Allentown, NJ
- NPI 1093666729
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Metuchen, NJ
- NPI 1104780303
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Bordentown, NJ
- NPI 1124532692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565136000000",
"number": "1053966986",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 MAIN ST APT 812",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070246909",
"telephone_number": "215-409-5519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNREACH",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"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": []
}
Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.