Active NPI
Bonnie Brae
- Mental Illness Community Based Residential Treatment Facility
- Baking Ridge, NJ
National Provider Identifier
1245689686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 1060
- Legal business name
- BONNIE BRAE
- Practice address
- 3415 Valley Road
Baking Ridge, NJ 07920-2655 - Phone
- (908) 647-0800
- Fax
- (908) 647-5021
- NPI assigned
- Jun 7, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Megan Jill Macdonald
- Title
- Accountant
- Phone
- (908) 542-2736
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 1060 | NJ | Primary |
Addresses
Primary practice location
3415 Valley Road
Baking Ridge, NJ 07920-2655
Mailing address
PO Box 825
Liberty Corner, NJ 07938-0825
Phone (908) 647-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8372403 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Bonnie Brae
Other organizations with this tax ID 12
Organizations that report the same tax identification number in the National Provider Directory.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1003081605
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1235405689
-
- Psychiatric Residential Treatment Facility
- Liberty Corner, NJ
- NPI 1447885520
-
- Mental Illness Community Based Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1497152961
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Liberty Corner, NJ
- NPI 1508220922
-
- Psychiatric Residential Treatment Facility
- Liberty Corner, NJ
- NPI 1578214631
-
- Children's Substance Abuse Rehabilitation Facility
- Liberty Corner, NJ
- NPI 1780291542
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Liberty Corner, NJ
- NPI 1831448414
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1831522523
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1871768564
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Basking Ridge, NJ
- NPI 1902071509
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Liberty Corner, NJ
- NPI 1912063702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1465257600000",
"number": "1245689686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 825",
"city": "LIBERTY CORNER",
"state": "NJ",
"postal_code": "079380825",
"telephone_number": "908-647-0800",
"fax_number": "908-647-5021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 VALLEY ROAD",
"city": "BAKING RIDGE",
"state": "NJ",
"postal_code": "079202655",
"telephone_number": "908-647-0800",
"fax_number": "908-647-5021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BONNIE BRAE",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-07",
"last_updated": "2016-06-07",
"status": "A",
"authorized_official_last_name": "MACDONALD",
"authorized_official_first_name": "MEGAN",
"authorized_official_middle_name": "JILL",
"authorized_official_title_or_position": "ACCOUNTANT",
"authorized_official_telephone_number": "908-542-2736",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "NJ",
"license": "1060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8372403",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.