NPIMap

Organization Active NPI

The Arc Ocean County Chapter, Inc.

Doing business as Supportive Living 111 Northrup Drive

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Brick, NJ
National Provider Identifier
1205216702
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
THE ARC OCEAN COUNTY CHAPTER, INC.
Doing business as
Supportive Living 111 Northrup Drive
Practice address
111 Northrup Dr
Brick, NJ 08724-2021
Phone
(732) 363-3335
Fax
(732) 363-2485
NPI assigned
Jun 1, 2015
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Laura Williams
Title
Executive Director
Phone
(732) 363-3335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

111 Northrup Dr
Brick, NJ 08724-2021

Mailing address

815 Cedar Bridge Ave
Lakewood, NJ 08701-4932
Phone (732) 363-3335

Other identifiers 1

IdentifierTypeStateIssuer
0463027MedicaidNJ

Other names 1

  • Supportive Living 111 Northrup Drive Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Arc Ocean County Chapter Inc106 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1205216702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 CEDAR BRIDGE AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014932",
            "telephone_number": "732-363-3335",
            "fax_number": "732-363-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTHRUP DR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242021",
            "telephone_number": "732-363-3335",
            "fax_number": "732-363-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OCEAN COUNTY CHAPTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-363-3335"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463027",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supportive Living 111 Northrup Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.