College Recovery LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

00038910 Issued in NJ

Legal business name

COLLEGE RECOVERY LLC

Practice address

104 Bayard St
New Brunswick, NJ 08901-2389

Phone

(310) 528-6370

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Philip Chasin

Title

Owner

Phone

(310) 528-6370

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

College Recovery LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• College Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New Brunswick, NJ
  • NPI 1114757739
  NPD tax ID
• College Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • New Brunswick, NJ
  • NPI 1467852798
  NPD tax ID

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1376996009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BAYARD ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BAYARD ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012389",
            "telephone_number": "310-528-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "CHASIN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-528-6370"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "00038910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter D Cole, MD
• Andrew Joseph Colgan Jr., MD
• Michele Colin
• Tracy Colin, RD
• College Recovery LLC
• College Recovery LLC
• Dylan Collier, PA-C
• Christine Anne Collins
• Valerie Collins, MD
• Deannon Colon, MD

• Clinical Medical Laboratory in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.