NPIMap

Organization Active NPI

Seabrook House, Inc.

Doing business as Seabrook

  • Substance Abuse Rehabilitation Facility
  • Seabrook, NJ
National Provider Identifier
1427110774
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
80650 Issued in NJ
Legal business name
SEABROOK HOUSE, INC.
Doing business as
Seabrook
Practice address
133 Polk LN
Seabrook, NJ 08302-5905
Phone
(856) 455-7575
Fax
(856) 452-1022
NPI assigned
Dec 14, 2006
Organization subpart
Yes
Parent organization
SEABROOK HOUSE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Mrs. Crystal Rebecca Smith
Title
Quality Manager
Phone
(856) 455-7575

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 80650 NJ Primary
Substance Abuse Rehabilitation Facility 324500000X 22585 NJ

Addresses

Primary practice location

133 Polk LN
Seabrook, NJ 08302-5905

Mailing address

133 Polk LN
Seabrook, NJ 08302-5905
Phone (856) 455-7575

Other identifiers 1

IdentifierTypeStateIssuer
5487302MedicaidNJ

Other names 1

  • Seabrook Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seabrook House Inc5 organizations share this tax ID, including this one
Part of
Seabrook House Inc

Other organizations with this tax ID 4

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

Locations

133 Polk Ln
Bridgeton, NJ 08302
Phone (800) 761-7575

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1427110774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 POLK LN",
            "city": "SEABROOK",
            "state": "NJ",
            "postal_code": "083025905",
            "telephone_number": "856-455-7575",
            "fax_number": "856-452-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 POLK LN",
            "city": "SEABROOK",
            "state": "NJ",
            "postal_code": "083025905",
            "telephone_number": "856-455-7575",
            "fax_number": "856-452-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEABROOK HOUSE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEABROOK HOUSE, INC.",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "QUALITY MANAGER",
        "authorized_official_telephone_number": "856-455-7575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NJ",
            "license": "80650",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NJ",
            "license": "22585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5487302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seabrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seabrook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.