Maryville, Inc
Organization Active NPI Substance Abuse Rehabilitation Facility · Pemberton, NJ
NPI 1306346325 · NPPES record last updated Aug 1, 2018
Key facts
- NPI
- 1306346325
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 1000140 (NJ)
- Legal business name
- MARYVILLE, INC
- Practice address
- 610 Pemberton Browns Mills Rd
Pemberton, NJ 08068 - Phone
- (609) 321-6263
- Fax
- (609) 283-0262
- NPI assigned
- Feb 16, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Jared Levy
- Title
- Cfo
- Phone
- (856) 863-3913
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Maryville Inc
Locations
129 Johnson Rd
Ste 7
Turnersville, NJ 08012
Phone (856) 227-2717
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 1000140 | NJ | Yes |
Addresses
Primary practice location
610 Pemberton Browns Mills Rd
Pemberton, NJ 08068
Mailing address
129 Johnson Rd Ste 7
Turnersville, NJ 08012-1777
Phone (856) 863-3913
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000140 | Other | NJ | STATE OF NEW JERSEY OFFICE OF LICENSING |
Other names
- MARYVILLE ADDICTION TREATMENT CENTER
Other providers in Pemberton, NJ
- Avrohom Lifschitz
- Renuka Maringanti
- Frances Marquez
- Taylor Martelack
- Sarah Martin
- Maryville, Inc
- Candace Lenore McDade
- Courtney McLaren
- Merakey New Jersey
- Jaclyn S Merrill
All providers in Pemberton, NJ · Substance Abuse Rehabilitation Facility in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.