NPIMap

Organization Active NPI

Four Corners Community Services LLC

Doing business as Four Corners Community Services

  • Occupational Therapist
  • Belleville, NJ
National Provider Identifier
1164009627
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
FOUR CORNERS COMMUNITY SERVICES LLC
Doing business as
Four Corners Community Services
Practice address
209 Passaic Ave
Belleville, NJ 07109-1960
Phone
(973) 392-0430
NPI assigned
Mar 29, 2021
Last updated
Mar 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Ama J Baffoe, RN
Title
Director
Phone
(973) 392-0430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

209 Passaic Ave
Belleville, NJ 07109-1960

Mailing address

209 Passaic Ave
Belleville, NJ 07109-1960
Phone (973) 392-0430

Other names 1

  • Four Corners Community Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fccsnj@outlook.com Other

National Provider Directory

National Provider Directory
Tax ID family
Four Corners Community Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1164009627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PASSAIC AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091960",
            "telephone_number": "973-392-0430",
            "fax_number": "973-392-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PASSAIC AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091960",
            "telephone_number": "973-392-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "BAFFOE",
        "authorized_official_first_name": "AMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-392-0430",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fccsnj@outlook.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "fccsnj@outlook.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "209 Passaic Ave Fl 1",
            "city": "Belleville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071091960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Four Corners Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.