NPIMap

Organization Active NPI

Vantage Health System, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Englewood, NJ
National Provider Identifier
1124499033
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2000117 Issued in NJ
Legal business name
VANTAGE HEALTH SYSTEM, INC
Practice address
93 W Palisade Ave
Englewood, NJ 07631-2611
Phone
(201) 385-4400
Fax
(201) 384-7067
NPI assigned
Oct 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Betty Treloar
Title
Patient Account Manager
Phone
(201) 385-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2000117 NJ Primary

Addresses

Primary practice location

93 W Palisade Ave
Englewood, NJ 07631-2611

Mailing address

2 Park Ave
Dumont, NJ 07628-3004
Phone (201) 385-4400

Other identifiers 1

IdentifierTypeStateIssuer
7759509MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Community CNTR for MNTL10 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": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1124499033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARK AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076283004",
            "telephone_number": "201-385-4400",
            "fax_number": "201-384-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312611",
            "telephone_number": "201-385-4400",
            "fax_number": "201-384-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "TRELOAR",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "PATIENT ACCOUNT MANAGER",
        "authorized_official_telephone_number": "201-385-4400"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "2000117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7759509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.