NPIMap

Organization Active NPI

Iep Youth Services, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Freehold, NJ
National Provider Identifier
1104184506
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
4140 Issued in NJ
Legal business name
IEP YOUTH SERVICES, INC.
Practice address
75 W Main St
Freehold, NJ 07728-2114
Phone
(732) 431-2663
Fax
(732) 409-3634
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Sharon Goldman, CPA
Title
Cfo
Phone
(732) 431-2663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 4140 NJ Primary

Addresses

Primary practice location

75 W Main St
Freehold, NJ 07728-2114

Mailing address

75 W Main St
Freehold, NJ 07728-2114
Phone (732) 431-2663

Other identifiers 1

IdentifierTypeStateIssuer
0285862MedicaidNJ

Other names 1

  • Step Ahead Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Iep Youth Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1104184506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282114",
            "telephone_number": "732-431-2663",
            "fax_number": "732-409-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282114",
            "telephone_number": "732-431-2663",
            "fax_number": "732-409-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IEP YOUTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "732-431-2663",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NJ",
            "license": "4140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0285862",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Step Ahead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.