A.W. Holdings, LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Gibbstown, NJ
NPI 1356908487 · NPPES record last updated May 23, 2019
Key facts
- NPI
- 1356908487
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- A.W. HOLDINGS, LLC
- Practice address
- 24 E Broad St
Gibbstown, NJ 08027-1420 - Phone
- (856) 457-8001
- NPI assigned
- May 23, 2019
- Organization subpart
- No
Authorized official
- Name
- Nancy Ann Bobay
- Title
- Chief Compliance Officer
- Phone
- (260) 207-5604
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Aw Holdings LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
24 E Broad St
Gibbstown, NJ 08027-1420
Mailing address
8515 Bluffton Rd
Fort Wayne, IN 46809-3022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 465526 | Medicaid | NJ |
Other names
- Benchmark Human Services
NPI Registry JSON
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1558569600000",
"number": "1356908487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8515 BLUFFTON RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468093022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 E BROAD ST",
"city": "GIBBSTOWN",
"state": "NJ",
"postal_code": "080271420",
"telephone_number": "856-457-8001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "A.W. HOLDINGS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-23",
"last_updated": "2019-05-23",
"status": "A",
"authorized_official_last_name": "BOBAY",
"authorized_official_first_name": "NANCY",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
"authorized_official_telephone_number": "260-207-5604"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "465526",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Benchmark Human Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gibbstown, NJ
- Advoserv of New Jersey, Inc.
- Advoserv of New Jersey, Inc.
- Akshay S Dave MD LLC
- Assoc. for Retarded Citizens, Inc. Goucester County
- Carter Global Healthcare LLC
All providers in Gibbstown, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment 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 May 23, 2019. 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.