NPIMap

Organization Active NPI

Crescent Ave Supported Living

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Woodbury, NJ
National Provider Identifier
1457867368
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
CRESCENT AVE SUPPORTED LIVING
Practice address
125 Crescent Ave
Woodbury, NJ 08096-5001
Phone
(856) 767-3650
NPI assigned
Dec 15, 2017
Last updated
Dec 15, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ARC OF CAMDEN COUNTY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Authorized official

Name
Michelle Schwarz
Title
Billing
Phone
(856) 768-8801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

125 Crescent Ave
Woodbury, NJ 08096-5001

Mailing address

215 W White Horse Pike
Berlin, NJ 08009-1132

National Provider Directory

National Provider Directory
Tax ID family
Arc of Camden County Chanticleer Drive Supported Living65 organizations share this tax ID, including this one
Part of
Arc of Camden County Chanticleer Drive Supported Living

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513296000000",
    "number": "1457867368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W WHITE HORSE PIKE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CRESCENT AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965001",
            "telephone_number": "856-767-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT AVE SUPPORTED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARC OF CAMDEN COUNTY, INC.",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A",
        "authorized_official_last_name": "SCHWARZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "856-768-8801"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.