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Cumberland County Guidance Center

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Millville, NJ

NPI 1447337134 · NPPES record last updated Mar 12, 2012

Key facts

NPI
1447337134
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
CUMBERLAND COUNTY GUIDANCE CENTER
Practice address
2038 Carmel Rd
Millville, NJ 08332-9754
Phone
(856) 825-6810
Fax
(856) 327-4281
NPI assigned
Nov 1, 2006
Organization subpart
No

Authorized official

Name
Mr. H Dieter Hovermann, MA
Title
Executive Director
Phone
(856) 825-6819

Corporate family (same tax ID) 9

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

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050504000986 NJ Part B Supplier - Clinic/Group Practice 0345280814 Receives reassigned benefits from 28 practitioners
Practice locations: Millville, NJ

National Provider Directory

Tax ID family
Cumberland County Guidance Center (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

2038 Carmel Rd
Millville, NJ 08332-9754

Mailing address

PO Box 808
2038 Carmel Road
Millville, NJ 08332
Phone (856) 825-6810

Other identifiers

IdentifierTypeStateIssuer
0083704MedicaidNJ
4549007MedicaidNJ
0036706MedicaidNJ
8819505MedicaidNJ
7945809MedicaidNJ
0036722MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 12, 2012.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1447337134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "address_2": "2038 CARMEL ROAD",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "08332",
            "telephone_number": "856-825-6810",
            "fax_number": "856-327-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2038 CARMEL RD",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083329754",
            "telephone_number": "856-825-6810",
            "fax_number": "856-327-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND COUNTY GUIDANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "HOVERMANN",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "DIETER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-825-6819",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083704",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4549007",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036706",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8819505",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7945809",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036722",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millville, NJ

All providers in Millville, NJ · Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

Sources for this page

Verify at the official NPI Registry.