Endeavor House North

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ENDEAVOR HOUSE NORTH

Practice address

206 Bergen Ave
Kearny, NJ 07032-3384

Phone

(732) 210-0509

Fax

(732) 542-1948

NPI assigned

Feb 22, 2019

Organization subpart

No

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

Authorized official

Name

Gilbert Yates

Title

Contract Manager

Phone

(877) 262-7803

Specialties & licenses 3

Addresses

Other names 1

• AW II LLC Doing business as

Tax ID family

Aw II LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Endeavor House North

  • Community/Behavioral Health Agency
  • Kearny, NJ
  • NPI 1053068502
  NPD tax ID

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1154888469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BERGEN AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323384",
            "telephone_number": "732-210-0509",
            "fax_number": "732-542-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BERGEN AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323384",
            "telephone_number": "732-210-0509",
            "fax_number": "732-542-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR HOUSE NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "877-262-7803"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AW II LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohamed Elsayed Elsamra
• Emad Jacob, MD PC
• Emergency Associates of Kearny, P.a.
• Oyenike O. Emiola, PMHNP- BC
• Endeavor House North
• Endeavor House North
• Martin Faquan Escourse Sr.
• David Esteves, B.S., ARDMS
• Tia Araceli Evangelista, PT, DPT
• Kyle Everage

• Substance Abuse Rehabilitation Facility in Kearny, NJ
• Providers in Kearny, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.