Vintage R Care Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

VINTAGE R CARE INC

Practice address

74 Mason St
Metuchen, NJ 08840-2947

Phone

(718) 419-2476

NPI assigned

Oct 10, 2022

Organization subpart

No

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

Authorized official

Name

Kadian WilliamsNPI 1023764842

Title

Ceo

Phone

(718) 419-2476

Specialties & licenses 1

Addresses

Other names 1

• Vintage R Care INC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kadian L Williams

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Metuchen, NJ
  • NPI 1023764842

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1205551405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 WOODMONT LN NW # 1173",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MASON ST",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402947",
            "telephone_number": "718-419-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE R CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KADIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-419-2476"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage R Care INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vintage R Care INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.