NPIMap

Organization Active NPI

Dungarvin New Jersey, LLC - Whitehead II

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ewing, NJ
National Provider Identifier
1114493244
Registry record updated Apr 27, 2023
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
DUNGARVIN NEW JERSEY, LLC - WHITEHEAD II
Practice address
1015 Whitehead Road Extension, Apt 209 & 217
Ewing, NJ 08638
Phone
(732) 463-7227
NPI assigned
Oct 16, 2018
Organization subpart
Yes
Parent organization
DUNGARVIN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Lori Kess
Title
Ceo
Phone
(651) 699-0206

Specialties & licenses 1

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

Addresses

Primary practice location

1015 Whitehead Road Extension, Apt 209 & 217
Ewing, NJ 08638

Mailing address

1543 State Route 27 Ste 24
Somerset, NJ 08873-4015
Phone (732) 463-7227

Other identifiers 1

IdentifierTypeStateIssuer
0494275MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Dungarvin New Jersey LLC - Alberta40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1114493244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 STATE ROUTE 27 STE 24",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734015",
            "telephone_number": "732-463-7227",
            "fax_number": "732-463-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WHITEHEAD ROAD EXTENSION, APT 209 & 217",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "08638",
            "telephone_number": "732-463-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN NEW JERSEY, LLC - WHITEHEAD II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2018-10-16",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "KESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-699-0206"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0494275",
            "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 Apr 27, 2023; 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.