NPIMap

Organization Active NPI

Family Service Bureau of Newark

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kearny, NJ
National Provider Identifier
1396994588
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
2000025-04 Issued in NJ
Legal business name
FAMILY SERVICE BUREAU OF NEWARK
Practice address
379 Kearny Ave
Kearny, NJ 07032-2601
Phone
(201) 246-8077
Fax
(201) 955-6165
NPI assigned
Sep 12, 2008
Last updated
Oct 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
CHI Shu Chou, LPC, LCADC
Title
Director of Operation
Phone
(973) 412-2056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 2000025-04 NJ Primary

Addresses

Primary practice location

379 Kearny Ave
Kearny, NJ 07032-2601

Mailing address

274 S Orange Ave
2ND Floor
Newark, NJ 07103-2419
Phone (973) 412-2056

Other identifiers 1

IdentifierTypeStateIssuer
0597911MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Family Service Bureau of Newark5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

379 Kearny Ave
Kearny, NJ 07032
Phone (201) 246-1357

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1396994588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 S ORANGE AVE",
            "address_2": "2ND FLOOR",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032419",
            "telephone_number": "973-412-2056",
            "fax_number": "973-484-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322601",
            "telephone_number": "201-246-8077",
            "fax_number": "201-955-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE BUREAU OF NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "CHOU",
        "authorized_official_first_name": "CHI SHU",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "973-412-2056",
        "authorized_official_credential": "LPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": "2000025-04",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0597911",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.