Organization Active NPI

Pennreach

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Woodbridge, NJ
National Provider Identifier
1285288688
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PENNREACH
Practice address
1482 Rahway Avenue
Apt. 106
Woodbridge, NJ 17001
Phone
(215) 409-5519
NPI assigned
Jul 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Krystal Odell
Title
Ceo
Phone
(215) 409-5519

Specialties & licenses 1

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

Addresses

Primary practice location

1482 Rahway Avenue
Apt. 106
Woodbridge, NJ 17001

Mailing address

18 S Main St
Allentown, NJ 08501-1610
Phone (215) 409-5519

National Provider Directory

National Provider Directory
Tax ID family
Pennreach87 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1285288688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 S MAIN ST",
            "city": "ALLENTOWN",
            "state": "NJ",
            "postal_code": "085011610",
            "telephone_number": "215-409-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1482 RAHWAY AVENUE",
            "address_2": "APT. 106",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "17001",
            "telephone_number": "215-409-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-409-5519"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.