NPIMap

Organization Active NPI

Lakewood Resource and Referral Center Inc

Doing business as Center for Health Education, Medicine and Dentistry

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
National Provider Identifier
1194436360
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LAKEWOOD RESOURCE AND REFERRAL CENTER INC
Doing business as
Center for Health Education, Medicine and Dentistry
Practice address
1171 River Avenue
Lakewood, NJ 08701
Phone
(732) 364-2144
Fax
(732) 364-3559
NPI assigned
Dec 8, 2022
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
David Friedman
Title
C.E.O.
Phone
(732) 364-2144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1171 River Avenue
Lakewood, NJ 08701

Mailing address

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Other names 1

  • Center for Health Education, Medicine and Dentistry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080307000331 NJ Part B Supplier - Clinic/Group Practice 6901981497 Receives reassigned benefits from 190 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, NJ; Lakewood, NJ
O20231227001161 NJ Part A Provider - Federally Qualified Health Center (FQHC) 6901981497 Practice locations: Lakewood, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194436360. Details of each certification follow.

Federally qualified health center certification: CCN 311000

Legal name
LAKEWOOD RESOURCE AND REFERRAL CENTER INC
Doing business as
CENTER FOR HEALTH EDUCATION, MEDICINE AND DENTISTRY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 27, 2023
Last certification
Dec 27, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1171 River Ave
Lakewood, NJ 87015610

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2278858Center for Health Education1171 River Avenue, Lakewood, NJ 08701Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Resource and Referral Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Friedman Individual Corporate OfficerCeo Jun 1, 2023
W-2 Managing EmployeeCeo Jun 1, 2023

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1194436360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-534-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 RIVER AVENUE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-364-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD RESOURCE AND REFERRAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "732-364-2144"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Health Education, Medicine and Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.