NPIMap

Organization Active NPI

Sovereign Health of New Jersey

  • Substance Abuse Rehabilitation Facility
  • Newark, NJ
National Provider Identifier
1386015204
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SOVEREIGN HEALTH OF NEW JERSEY
Practice address
495 N 13TH St
Newark, NJ 07107-1317
Phone
(949) 276-5553
Fax
(949) 542-4586
NPI assigned
Oct 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Mr. Tonmoy Sharma
Title
Owner
Phone
(949) 276-5553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

495 N 13TH St
Newark, NJ 07107-1317

Mailing address

1221 Puerta del Sol
Suite 280
San Clemente, CA 92673-6308
Phone (949) 276-5553

National Provider Directory

National Provider Directory
Tax ID family
Sovereign Health of Massachusetts Inc2 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.

Locations

1221 Puerta del Sol
Ste 280
San Clemente, CA 92673

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1386015204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PUERTA DEL SOL",
            "address_2": "SUITE 280",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736308",
            "telephone_number": "949-276-5553",
            "fax_number": "949-542-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "949-276-5553",
            "fax_number": "949-542-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTH OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "TONMOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-276-5553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.