Organization Active NPI

Future Hope Mental Care of NJ

  • Psychiatric/Mental Health Registered Nurse
  • Maplewood, NJ
National Provider Identifier
1114542370
Registry record updated Jun 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Legal business name
FUTURE HOPE MENTAL CARE OF NJ
Practice address
16 Brookwood Dr
Maplewood, NJ 07040-1905
Phone
(973) 885-7496
NPI assigned
Jun 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2020

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

Authorized official

Name
Callister C IbeNPI 1245466028
Title
Owner
Phone
(973) 885-7496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X Primary

Addresses

Primary practice location

16 Brookwood Dr
Maplewood, NJ 07040-1905

Mailing address

16 Brookwood Dr
Maplewood, NJ 07040-1905
Phone (973) 885-7496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200629000877 NJ Part B Supplier - Clinic/Group Practice 9931521515 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592006400000",
    "number": "1114542370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BROOKWOOD DR",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401905",
            "telephone_number": "973-885-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BROOKWOOD DR",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401905",
            "telephone_number": "973-885-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUTURE HOPE MENTAL CARE OF NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A",
        "authorized_official_last_name": "IBE",
        "authorized_official_first_name": "CALLISTER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-885-7496"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.