College Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

COLLEGE RECOVERY LLC

Practice address

23 Duke St
New Brunswick, NJ 08901-1738

Phone

(732) 402-0677

Fax

(732) 626-6797

NPI assigned

Aug 22, 2014

Last updated

Oct 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Isaac Glasman

Title

Director

Phone

(817) 806-9662

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

College Recovery LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• College Recovery LLC

  dba SOBA New Jersey

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New Brunswick, NJ
  • NPI 1114757739
  NPD tax ID
• College Recovery LLC

  • Clinical Medical Laboratory
  • New Brunswick, NJ
  • NPI 1376996009
  NPD tax ID

Locations

Practitioners 3

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.

• Jesse Wayland Adams II, LCSW

  • Clinical Social Worker
  • Asbury Park, NJ
  • NPI 1942711130
  NPD (past)
• Jeffrey A Berman, M.D.

  • Addiction Psychiatry Physician
  • Teaneck, NJ
  • NPI 1336175256
  NPD (past)
• Joshua Baradale Collins, LCSW, LCADC

  • Clinical Social Worker
  • Bridgewater, NJ
  • NPI 1558829952
  NPD (past)

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1467852798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BAYARD ST",
            "address_2": "SUITE 1",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012102",
            "telephone_number": "917-806-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 DUKE ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011738",
            "telephone_number": "732-402-0677",
            "fax_number": "732-626-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Bayard St",
            "address_2": "SUITE 1",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089012102",
            "country_code": "US",
            "telephone_number": "917-806-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLEGE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "GLASMAN",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-806-9662",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HUMAN SERVICES",
            "identifier": "2000540",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HUMAN SERVICES",
            "identifier": "1000153",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Joseph Colgan Jr., MD
• Michele Colin
• Tracy Colin, RD
• College Recovery LLC (SOBA New Jersey)
• College Recovery LLC
• Dylan Collier, PA-C
• Christine Anne Collins
• Valerie Collins, MD
• Deannon Colon, MD
• Coming Home of Middlesex County, Inc.

• Substance Abuse Rehabilitation Facility in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.