NPIMap

Organization Active NPI

Preferred Behavioral Health of New Jersey, Inc

  • Community/Behavioral Health Agency
  • Lakewood, NJ
National Provider Identifier
1467519728
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
20302-12-05 Issued in NJ
Legal business name
PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC
Practice address
700 Airport Road
Preferred Behavioral Health Dare Program
Lakewood, NJ 08701
Phone
(732) 367-4700
Fax
(732) 364-2253
NPI assigned
Jan 3, 2007
Last updated
Mar 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Julie Vanore
Title
Cao
Phone
(732) 458-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 20302-12-05 NJ Primary

Addresses

Primary practice location

700 Airport Road
Preferred Behavioral Health Dare Program
Lakewood, NJ 08701

Mailing address

P.O. Box 2036
Preferred Behavioral Health of New Jersey
Lakewood, NJ 08701
Phone (732) 458-1700

Other identifiers 1

IdentifierTypeStateIssuer
5348501MedicaidNJ

Other names 1

  • Dare Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050629000660 NJ Part B Supplier - Clinic/Group Practice 3971414533 Receives reassigned benefits from 51 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toms River, NJ; Lakewood, NJ; Eatontown, NJ; Brick, NJ; Barnegat, NJ

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Preferred Behavioral Health of NJ Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1467519728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2036",
            "address_2": "PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-458-1700",
            "fax_number": "732-785-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AIRPORT ROAD",
            "address_2": "PREFERRED BEHAVIORAL HEALTH DARE PROGRAM",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "VANORE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "732-458-1700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "20302-12-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5348501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dare Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dare Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.