NPIMap

Organization Active NPI

John Brooks Recovery Center, a New Jersey Non-Profit Corporation

  • Federally Qualified Health Center (FQHC)
  • Atlantic City, NJ
National Provider Identifier
1437605656
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
2000466 Issued in NJ
Legal business name
JOHN BROOKS RECOVERY CENTER, A NEW JERSEY NON-PROFIT CORPORATION
Practice address
1931 Bacharach Blvd
Atlantic City, NJ 08401
Phone
(609) 345-2020
Fax
(609) 646-7027
NPI assigned
Aug 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Mr. Douglas Hacker
Title
Cfo/Coo
Phone
(609) 345-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2000466 NJ Primary

Addresses

Primary practice location

1931 Bacharach Blvd
Atlantic City, NJ 08401

Mailing address

660 Black Horse Pike
Pleasantville, NJ 08232
Phone (609) 345-2020

Other identifiers 1

IdentifierTypeStateIssuer
0101702MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
John Brooks Recovery Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1437605656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BLACK HORSE PIKE",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "08232",
            "telephone_number": "609-345-2020",
            "fax_number": "609-646-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 BACHARACH BLVD",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "08401",
            "telephone_number": "609-345-2020",
            "fax_number": "609-646-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN BROOKS RECOVERY CENTER, A NEW JERSEY NON-PROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "HACKER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "609-345-2020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "2000466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.