NPIMap

Organization Active NPI

Center for Humanistic Change of NJ, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bloomingdale, NJ
National Provider Identifier
1245765106
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
GH347 Issued in NJ
Legal business name
CENTER FOR HUMANISTIC CHANGE OF NJ, INC.
Practice address
17 Grove St
Bloomingdale, NJ 07403-1607
Phone
(973) 838-7756
NPI assigned
Apr 27, 2017
Last updated
Nov 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Mr. Paul Steven Kucinski
Title
Executive Director
Phone
(973) 691-3488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH347 NJ Primary

Addresses

Primary practice location

17 Grove St
Bloomingdale, NJ 07403-1607

Mailing address

12 US Highway 206
Stanhope, NJ 07874-3269
Phone (973) 691-3488

Other identifiers 1

IdentifierTypeStateIssuer
0553891MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Center for Humanistic Change of NJ Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1245765106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 US HIGHWAY 206",
            "city": "STANHOPE",
            "state": "NJ",
            "postal_code": "078743269",
            "telephone_number": "973-691-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GROVE ST",
            "city": "BLOOMINGDALE",
            "state": "NJ",
            "postal_code": "074031607",
            "telephone_number": "973-838-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HUMANISTIC CHANGE OF NJ, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "KUCINSKI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-691-3488",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "GH347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0553891",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.