South Jersey Drug Treatment Center

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

22415 Issued in NJ

Legal business name

SOUTH JERSEY DRUG TREATMENT CENTER

Doing business as

South Jersey Drug Treatment Center

Practice address

162 Sunny Slope Dr
Bridgeton, NJ 08302-5732

Phone

(856) 455-5441

Fax

(856) 455-0505

NPI assigned

May 22, 2007

Last updated

Jan 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mary I Reimer, LPC, LCADC, ACS, CCSNPI 1619362399

Title

Executive Director

Phone

(609) 805-2986

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 3

• SOUTH JERSEY DRUG TREATMENT CENTER Doing business as
• SJDTC Other name
• South Jersey Drug Treatment Other name

Medicare fee-for-service enrollment

Enrolled in NJ

Opioid treatment program

Medicare-enrolled since Jun 9, 2020

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Mary Reimer

  • Mental Health Counselor
  • Bridgeton, NJ
  • NPI 1619362399
  NPD Authorized official
• Myangel A Davis

  • Addiction (Substance Use Disorder) Counselor
  • Bridgeton, NJ
  • NPI 1083482509
  NPD
• Stephanie L. Stowe

  • Addiction (Substance Use Disorder) Counselor
  • Bridgeton, NJ
  • NPI 1528806502
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1184833550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083020457",
            "telephone_number": "856-455-5441",
            "fax_number": "856-455-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 SUNNY SLOPE DR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083025732",
            "telephone_number": "856-455-5441",
            "fax_number": "856-455-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY DRUG TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "REIMER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "609-805-2986",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, LCADC, ACS, CCS"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NJ",
            "license": "22415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH JERSEY DRUG TREATMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SJDTC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SJDTC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "South Jersey Drug Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael Simpson
• Sleepcare Centers Inc.
• Stacey L Smick, PA
• Elvira K. Smith, MA, CSW
• South Cumberland Medical Associates PC
• South Jersey Eye Associates PA
• South Jersey Hearing and Tinnitus, LLC
• Ashley Soyer
• Liliam Meredith Spieker
• Sprague Dialysis LLC (Bridgeton Dialysis)

• Methadone Clinic in Bridgeton, NJ
• Providers in Bridgeton, NJ by specialty
• Methadone Clinic in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.