Our Special Place, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0100983768 Issued in NJ

Legal business name

OUR SPECIAL PLACE, INC.

Practice address

62 Broad St
Matawan, NJ 07747-2534

Phone

(732) 765-8500

NPI assigned

Jan 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Dawn Fittipaldi, MS. BCBANPI 1245785336

Title

Educational Director/Vice President

Phone

(732) 765-8500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Dawn Fittipaldi, BCBA

  • Behavior Analyst
  • Matawan, NJ
  • NPI 1245785336
  NPD (past) Authorized official
• Juliana Bornhorst Estrella, BCBA

  • Behavior Analyst
  • Matawan, NJ
  • NPI 1508420852
  NPD (past)

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1154788057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BROAD ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472534",
            "telephone_number": "732-765-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BROAD ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472534",
            "telephone_number": "732-765-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR SPECIAL PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "FITTIPALDI",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "EDUCATIONAL DIRECTOR/VICE PRESIDENT",
        "authorized_official_telephone_number": "732-765-8500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS. BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "0100983768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.