SNJ Recovery Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SNJ RECOVERY CENTER LLC

Practice address

204 Grove Ave Ste C
West Deptford, NJ 08086-2557

Phone

(754) 213-6635

NPI assigned

Feb 1, 2024

Organization subpart

No

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

Authorized official

Name

Joseph Coyle

Title

Ceo

Phone

(754) 212-6635

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1265295463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE STE C",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862557",
            "telephone_number": "754-213-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE STE C",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862557",
            "telephone_number": "754-213-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNJ RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "754-212-6635"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda L Short, LPC
• Jamie M Sikora, APN
• David Michael Sileo, RN MS ACNP-BC
• Paul A. Simons, DDS
• Bradley J Smith, MD
• Christoph N Spanos, BA, MA, PSYD
• Michael Anthony Sparich, MS OTR/L
• Alyson McKay Stahler
• Rebecca Jean Stanwood, C.P.N.P
• Stuart a Wasserlauf DDS PA

• Substance Abuse Rehabilitation Facility in West Deptford, NJ
• Providers in West Deptford, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.