NPIMap

Organization Active NPI

Recovery Centers of America at Manahawkin NJ Medicaid Only

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Manahawkin, NJ
National Provider Identifier
1366979494
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
RECOVERY CENTERS OF AMERICA AT MANAHAWKIN NJ MEDICAID ONLY
Practice address
400 N Main St Ste 2
Manahawkin, NJ 08050-3730
Phone
(610) 994-2900
NPI assigned
May 19, 2017
Reactivated
Feb 4, 2019
Organization subpart
Yes
Parent organization
TRC-OC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Kevin McClure
Title
Cfo
Phone
(610) 994-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

400 N Main St Ste 2
Manahawkin, NJ 08050-3730

Mailing address

2201 Renaissance Blvd FL 3
King of Prussia, PA 19406-2709
Phone (610) 994-2900

National Provider Directory

National Provider Directory
Tax ID family
5034 Atlantic Avenue Opco LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

400 N Main St
Ste 2
Manahawkin, NJ 08050
Phone (610) 994-2900

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": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1366979494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 RENAISSANCE BLVD FL 3",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062709",
            "telephone_number": "610-994-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST STE 2",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503730",
            "telephone_number": "610-994-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY CENTERS OF AMERICA AT MANAHAWKIN NJ MEDICAID ONLY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRC-OC LLC",
        "enumeration_date": "2017-05-19",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "deactivation_date": "2018-05-09",
        "reactivation_date": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-994-2900"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.