Elmlifelines

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

Organization subpart

No

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

Authorized official

Name

Ms. Mary A Beck, LCSW

Title

Director

Phone

(609) 654-4044

Specialties & licenses 1

Addresses

Other identifiers 1

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6913504",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rekha Eapen
• David F Eckel, DMD
• Eckerd Corporation
• Lynn Eiding, NP
• Elaines Way LLC
• Enhanced Chiropractic Corp
• Alfred Vasquez Enriquez, M.D.
• Allison Rae Epstein, MA, LPC
• Marissa Lynn Ercolani, RBT
• Bridget Esplund, PT, DPT

• Substance Use Disorder Rehabilitation Clinic/Center in Medford, NJ
• Providers in Medford, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• 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.