NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Clarksboro, NJ
National Provider Identifier
1326428392
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
GH960 Issued in NJ
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
271 Whiskey Mill Rd
Clarksboro, NJ 08020-1128
Phone
(856) 241-3320
Fax
(856) 241-3321
NPI assigned
Jun 4, 2015
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Darren Blough, M.S.W., BCABA
Title
State Director
Phone
(856) 241-3320

Corporate family (same tax ID) 24

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

National Provider Directory

National Provider Directory
Tax ID family
Advoserv of New Jersey Inc (92 organizations share this tax ID)
Part of
Advoserv of New Jersey Inc

Locations

271 Whiskey Mill Rd
Clarksboro, NJ 08020

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH960 NJ Primary

Addresses

NPPES NPI Registry

Primary practice location

271 Whiskey Mill Rd
Clarksboro, NJ 08020-1128

Mailing address

2520 Wrangle Hill Rd Ste 200
Bear, DE 19701-3856
Phone (302) 365-8050

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0463591MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 11, 2016.

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1326428392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WRANGLE HILL RD STE 200",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013856",
            "telephone_number": "302-365-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 WHISKEY MILL RD",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201128",
            "telephone_number": "856-241-3320",
            "fax_number": "856-241-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOSERV OF NEW JERSEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOSERV OF NEW JERSEY, INC.",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "BLOUGH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "STATE DIRECTOR",
        "authorized_official_telephone_number": "856-241-3320",
        "authorized_official_credential": "M.S.W., BCABA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "GH960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.