Ambrosia of New Jersey LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

AMBROSIA OF NEW JERSEY LLC

Doing business as

Pinelands Recovery Center of Medford

Practice address

287 Old Marlton Pike
Medford, NJ 08055-8761

Phone

(561) 578-8600

NPI assigned

Jan 4, 2019

Organization subpart

Yes

Parent organization

DISCOVERY PRACTICE MANAGEMENT, INCAs reported in NPPES

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

Authorized official

Name

William Bradley Cooper

Title

Cfo

Phone

(714) 947-7351

Specialties & licenses 1

Addresses

Other names 1

• Pinelands Recovery Center of Medford Doing business as

Locations

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1194298976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 KATELLA AVE",
            "address_2": "SUITE 111",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "714-828-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 OLD MARLTON PIKE",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558761",
            "telephone_number": "561-578-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBROSIA OF NEW JERSEY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DISCOVERY PRACTICE MANAGEMENT, INC",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-947-7351"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinelands Recovery Center of Medford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bernadette Alpajora, OTD
• Elpi Niki Altum, PT
• Rianna M Alvarado, AA, RBT CERT
• Ambrosia of Medford LLC (Pinelands Recovery Center of Medford)
• Ambrosia of Medford LLC (Pinelands Recovery Center of Medford)
• Elizabeth Backer Amisson, MS, RD, CDE
• Meaghan Marie Andre-Brown, D.O.
• Justin Andronico
• Jessica Kristi Angelone
• Barbara Scaff Angstadt, MSW

• Substance Abuse Rehabilitation Facility in Medford, NJ
• Providers in Medford, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.