NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Swedesboro, NJ
National Provider Identifier
1386159887
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
617 Auburn Ave Ste 101
Swedesboro, NJ 08085-1620
Phone
(856) 241-3320
NPI assigned
Dec 6, 2017
Last updated
Dec 6, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Authorized official

Name
Michael Wilder, MHSA
Title
Senior VP of Operations
Phone
(856) 241-3320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

617 Auburn Ave Ste 101
Swedesboro, NJ 08085-1620

Mailing address

510 Heron Dr Ste 114
Swedesboro, NJ 08085-1767

Other identifiers 1

IdentifierTypeStateIssuer
0463591MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Advoserv of New Jersey Inc92 organizations share this tax ID, including this one
Part of
Advoserv of New Jersey Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1386159887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HERON DR STE 114",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 AUBURN AVE STE 101",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851620",
            "telephone_number": "856-241-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOSERV OF NEW JERSEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOSERV OF NEW JERSEY, INC.",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SENIOR VP OF OPERATIONS",
        "authorized_official_telephone_number": "856-241-3320",
        "authorized_official_credential": "MHSA"
    },
    "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": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swedesboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.