Vine Community

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

GH1827 Issued in NJ

Legal business name

VINE COMMUNITY

Practice address

35 W Maple Ave
Merchantville, NJ 08109-5141

Phone

(856) 324-0288

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Amy Rohrer

Title

Executive Director

Phone

(856) 324-0288

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1104377258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W MAPLE AVE",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081095141",
            "telephone_number": "856-324-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W MAPLE AVE",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081095141",
            "telephone_number": "856-324-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "ROHRER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-324-0288"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "GH1827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Michael Scardigli, MD
• Philip A Smyth III, LPC LCADC
• Lacondia Sundiata
• Two Hearts Community Services
• Kathryn E Valenzano, NP
• John A. Wallace, DPM
• Wellspring Center LLC
• Christina J White, LPN
• John G Wilson, M.D.
• Your Health Now LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Merchantville, NJ
• Providers in Merchantville, NJ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.