Ethan and the Bean a New Jersey Non Profit Corporation

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Legal business name

ETHAN AND THE BEAN A NEW JERSEY NON PROFIT CORPORATION

Practice address

31 Fairfield Avenue
West Caldwell, NJ 07006

Phone

(973) 303-9678

NPI assigned

Dec 18, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela Donovan

Title

President

Phone

(908) 403-5789

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1063984979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 FOREST AVENUE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "07006",
            "telephone_number": "973-303-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 FAIRFIELD AVENUE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "07006",
            "telephone_number": "973-303-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHAN AND THE BEAN A NEW JERSEY NON PROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "DONOVAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-403-5789",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Day Training/Habilitation Specialist in West Caldwell, NJ
• Providers in West Caldwell, NJ by specialty
• Day Training/Habilitation Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.