Pinnacle Treatment Centers NJ-I, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

PINNACLE TREATMENT CENTERS NJ-I, LLC

Doing business as

Lacey Treatment Services

Practice address

411 US Highway 9 Ste 1
Lanoka Harbor, NJ 08734-2818

Phone

(609) 357-4428

Fax

(609) 549-3972

NPI assigned

Sep 9, 2021

Organization subpart

No

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

Authorized official

Name

Robyn Tanis

Title

Executive Director of Contract MGMT

Phone

(856) 533-8762

Specialties & licenses 2

Addresses

Other names 1

• Lacey Treatment Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pinnacle Treatment Centers NJ-I, LLC

  • Methadone Clinic
  • Toms River, NJ
  • NPI 1184071151

  O20200309000506

  Same enrollment

Tax ID family

Lacey Treatment Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Pinnacle Treatment Centers NJ I Inc

  • Methadone Clinic
  • Toms River, NJ
  • NPI 1902075336
  NPD tax ID
• Pinnacle Treatment Centers NJ-I, LLC

  • Methadone Clinic
  • Toms River, NJ
  • NPI 1184071151
  NPD tax ID
• Pinnacle Treatment Centers NJ-I, LLC

  • Methadone Clinic
  • Lanoka Harbor, NJ
  • NPI 1770254807
  NPD tax ID

Locations

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1265101661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 US HIGHWAY 9 STE 1",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342818",
            "telephone_number": "609-357-4428",
            "fax_number": "609-549-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS NJ-I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lacey Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ezinne Oji
• Thankgod Okechukwu, LCADC
• Apollo Paranal
• Pathways to Serenity, LLC
• Alyssa Picone
• Pinnacle Treatment Centers NJ-I, LLC
• James M Quirk, PT
• Heather Jean Radecsky, RPH
• Vilma Ramos
• Rem New Jersey, Inc.

• Methadone Clinic in Lanoka Harbor, NJ
• Providers in Lanoka Harbor, NJ by specialty
• Methadone Clinic in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.