Organization Active NPI

The Passion Care Center

  • Professional Counselor
  • Perth Amboy, NJ
National Provider Identifier
1164913786
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
THE PASSION CARE CENTER
Practice address
187 Fayette St
Perth Amboy, NJ 08861-4140
Phone
(267) 909-8264
Fax
(215) 525-0272
NPI assigned
May 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Authorized official

Name
Omar Riley
Title
Account Manager
Phone
(267) 909-8264

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X NJ Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

187 Fayette St
Perth Amboy, NJ 08861-4140

Mailing address

187 Fayette St
Perth Amboy, NJ 08861-4140
Phone (267) 909-8264

Other identifiers 1

IdentifierTypeStateIssuer
0398012MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
The Passion Care Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

187 Fayette St
Perth Amboy, NJ 08861
Phone (732) 406-0021

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1164913786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 FAYETTE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614140",
            "telephone_number": "267-909-8264",
            "fax_number": "215-525-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 FAYETTE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614140",
            "telephone_number": "267-909-8264",
            "fax_number": "215-525-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PASSION CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "267-909-8264"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0398012",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.