NPIMap

Organization Active NPI

Elmlifelines

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Medford, NJ
National Provider Identifier
1184743403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
22484 Issued in NJ
Legal business name
ELMLIFELINES
Practice address
23 S Main St
Medford, NJ 08055-2444
Phone
(609) 654-4044
Fax
(609) 953-5060
NPI assigned
Mar 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary A Beck, LCSWNPI 1992912356
Title
Director
Phone
(609) 654-4044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 22484 NJ Primary

Addresses

Primary practice location

23 S Main St
Medford, NJ 08055-2444

Mailing address

23 S Main St
Medford, NJ 08055-2444
Phone (609) 654-4044

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184743403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 S MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552444",
            "telephone_number": "609-654-4044",
            "fax_number": "609-953-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552444",
            "telephone_number": "609-654-4044",
            "fax_number": "609-953-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMLIFELINES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "609-654-4044",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": "22484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.