NPIMap

Organization Active NPI

Services to Overcome Drug Abuse Among Teenagers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salem, NJ
National Provider Identifier
1104163658
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
2000040 Issued in NJ
Legal business name
SERVICES TO OVERCOME DRUG ABUSE AMONG TEENAGERS
Practice address
75 Market St
Salem, NJ 08079-1918
Phone
(856) 935-0441
NPI assigned
Jan 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Authorized official

Name
Denise Pooley
Title
Chief Financial Officer
Phone
(856) 475-1310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 2000040 NJ Primary

Addresses

Primary practice location

75 Market St
Salem, NJ 08079-1918

Mailing address

919 Broadway
Westville, NJ 08093-1436
Phone (856) 475-1310

Other practice location 1

919 Broadway
Westville, NJ 08093-1436
Phone (856) 475-1310

Other identifiers 1

IdentifierTypeStateIssuer
0289515MedicaidNJ

Other names 1

  • SODAT of NJ, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Services to Overcome Drug Abuse Among Teenagers Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1104163658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 BROADWAY",
            "city": "WESTVILLE",
            "state": "NJ",
            "postal_code": "080931436",
            "telephone_number": "856-475-1310",
            "fax_number": "856-475-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MARKET ST",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080791918",
            "telephone_number": "856-935-0441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 Broadway",
            "address_purpose": "LOCATION",
            "city": "Westville",
            "state": "NJ",
            "postal_code": "080931436",
            "country_code": "US",
            "telephone_number": "856-475-1310",
            "fax_number": "856-475-0055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERVICES TO OVERCOME DRUG ABUSE AMONG TEENAGERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "POOLEY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "856-475-1310"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": "2000040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0289515",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SODAT of NJ, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SODAT of NJ, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, NJ

Sources for this page

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