Endeavor Therapy Group LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

44SL05888100 Issued in NJ

Legal business name

ENDEAVOR THERAPY GROUP LLC

Practice address

6 Hegner CT
South Hackensack, NJ 07606-1701

Phone

(201) 888-3462

NPI assigned

Mar 8, 2016

Last updated

Mar 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Lynn Marino, LSW

Title

Executive Director

Phone

(201) 888-3462

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1255792982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEGNER CT",
            "city": "SOUTH HACKENSACK",
            "state": "NJ",
            "postal_code": "076061701",
            "telephone_number": "201-888-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HEGNER CT",
            "city": "SOUTH HACKENSACK",
            "state": "NJ",
            "postal_code": "076061701",
            "telephone_number": "201-888-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "201-888-3462",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "44SL05888100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in South Hackensack, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.