NPIMap

Organization Active NPI

Eastern Christian Children's Retreat

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Wyckoff, NJ
National Provider Identifier
1407511967
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
EASTERN CHRISTIAN CHILDREN'S RETREAT
Practice address
286 Newtown Rd
Wyckoff, NJ 07481-2606
Phone
(201) 848-8005
NPI assigned
Nov 1, 2021
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Laura Lupica
Title
Chief Operating Officer
Phone
(201) 848-8005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

286 Newtown Rd
Wyckoff, NJ 07481-2606

Mailing address

700 Mountain Ave
Wyckoff, NJ 07481-1099
Phone (201) 848-8005

Other identifiers 1

IdentifierTypeStateIssuer
A9109288MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Eastern Christian Children's Retreat21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1407511967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNTAIN AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811099",
            "telephone_number": "201-848-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 NEWTOWN RD",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812606",
            "telephone_number": "201-848-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CHRISTIAN CHILDREN'S RETREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "LUPICA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "201-848-8005"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A9109288",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.