NPIMap

Organization Active NPI

South Jersey Behavioral Health Resources, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Berlin, NJ
National Provider Identifier
1306365671
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
40301D051040 Issued in NJ
Legal business name
SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES, INC.
Practice address
4 Egg Harbor Rd
Berlin, NJ 08009-2019
Phone
(856) 309-6070
NPI assigned
Sep 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Authorized official

Name
Theresa Wilson
Title
President/Ceo
Phone
(856) 655-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 40301D051040 NJ Primary

Addresses

Primary practice location

4 Egg Harbor Rd
Berlin, NJ 08009-2019

Mailing address

2500 McClellan Ave Ste 300
Pennsauken, NJ 08109-0001
Phone (856) 361-1100

Other identifiers 1

IdentifierTypeStateIssuer
40301D051040OtherNJNJ DMHAS

National Provider Directory

National Provider Directory
Tax ID family
South Jersey Behavioral Health Resources Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

4 Egg Harbor Rd
Berlin, NJ 08009
Phone (856) 309-6070

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1306365671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MCCLELLAN AVE STE 300",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081090001",
            "telephone_number": "856-361-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EGG HARBOR RD",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092019",
            "telephone_number": "856-309-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "856-655-1211"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NJ",
            "license": "40301D051040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ DMHAS",
            "identifier": "40301D051040",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.