NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ewing, NJ
National Provider Identifier
1073099669
Registry record updated Jul 17, 2018
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
ADVOSERV OF NEW JERSEY, INC.
Practice address
56 Brophy Dr
Ewing, NJ 08638-1241
Phone
(856) 241-3320
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
Michael Wilder, MHSA
Title
Senior VP of Operations
Phone
(856) 241-3320

Specialties & licenses 1

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

Addresses

Primary practice location

56 Brophy Dr
Ewing, NJ 08638-1241

Mailing address

510 Heron Dr Ste 114
Swedesboro, NJ 08085-1767
Phone (856) 241-3320

Other identifiers 1

IdentifierTypeStateIssuer
0463591MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Advoserv of New Jersey Inc92 organizations share this tax ID, including this one
Part of
Advoserv of New Jersey Inc

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1073099669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HERON DR STE 114",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851767",
            "telephone_number": "856-241-3320",
            "fax_number": "856-241-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 BROPHY DR",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086381241",
            "telephone_number": "856-241-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOSERV OF NEW JERSEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOSERV OF NEW JERSEY, INC.",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SENIOR VP OF OPERATIONS",
        "authorized_official_telephone_number": "856-241-3320",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.