Merchantville Addiction Treatment LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MERCHANTVILLE ADDICTION TREATMENT LLC

Practice address

1 S Centre St
Merchantville, NJ 08109-2213

Phone

(800) 663-5548

NPI assigned

Jan 30, 2019

Organization subpart

No

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

Authorized official

Name

Jason Gooberman

Title

Ceo

Phone

(856) 449-6159

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1205390622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S CENTRE ST",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081092213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S CENTRE ST",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081092213",
            "telephone_number": "800-663-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCHANTVILLE ADDICTION TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "GOOBERMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-449-6159"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Markowitz, M.D.
• Taliah Mason
• David R McComb, D.O.
• Jill McKay, PT
• Karen Renee McRae
• Merchantville Medical
• Milestone Addiction Treatment LLC
• Cindy Morales-Butts, NBHWC
• Marian W Mote, CPNP
• Motherland Midwifery LLC

• Substance Abuse Rehabilitation Facility in Merchantville, NJ
• Providers in Merchantville, 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 30, 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.