Somerset Home for Temporarily Displaced Children

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

5070 Issued in NJ

Legal business name

SOMERSET HOME FOR TEMPORARILY DISPLACED CHILDREN

Practice address

16 4TH Ave
Bridgewater, NJ 08807-2004

Phone

(908) 526-6686

Fax

(908) 526-4242

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey Fetzko

Title

Executive Director

Phone

(908) 526-6605

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Passages Other name

Tax ID family

Passages2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Visions and Pathways

  • Mental Health Counselor
  • Bridgewater, NJ
  • NPI 1801403175
  NPD tax ID

Locations

Practitioners 1

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

• Katherine Huber, LCSW

  • Clinical Social Worker
  • Bridgewater, NJ
  • NPI 1396151601
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306968946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BRAHMA AVE",
            "address_2": "P.O. BOX 6781",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072758",
            "telephone_number": "908-526-6605",
            "fax_number": "908-526-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 4TH AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072004",
            "telephone_number": "908-526-6686",
            "fax_number": "908-526-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET HOME FOR TEMPORARILY DISPLACED CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FETZKO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "908-526-6605"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NJ",
            "license": "5070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8374708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passages",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebecca Cara Soltan, OTR/L
• Somerset Children'S Center
• Somerset Childrens Center
• Somerset County YMCA
• Somerset Foot and Ankle LLC
• Somerset Nephrology Associates, P.C.
• Somerset OBGYN Association
• Somerset Pulmonary and Critical Care Associates, PA
• Somerset Surgical Center
• Vidhu Soni

• Emotionally Disturbed Childrens' Residential Treatment Facility in Bridgewater, NJ
• Providers in Bridgewater, NJ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.