NPIMap

Organization Active NPI

Elmwood Hills Healthcare Center LLC

  • Psychiatric Hospital
  • Blackwood, NJ
National Provider Identifier
1487070793
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
ELMWOOD HILLS HEALTHCARE CENTER LLC
Practice address
425 Woodbury Turnersville Rd
Blackwood, NJ 08012-2960
Phone
(856) 374-6600
NPI assigned
Mar 11, 2014
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Abraham Feigenbaum
Title
Member
Phone
(732) 364-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

425 Woodbury Turnersville Rd
Blackwood, NJ 08012-2960

Mailing address

425 Woodbury Turnersville Rd
Blackwood, NJ 08012-2960

Other names 1

  • Northbrook Behavioral Health Hospital LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140922000998 NJ Part A Provider - Hospital 1951533983 Practice locations: Blackwood, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487070793. Details of each certification follow.

Hospital certification: CCN 314018

Legal name
ELMWOOD HILLS HEALTHCARE CENTER LLC
Doing business as
NORTHBROOK BEHAVIORAL HEALTH HOSPITAL LLC
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 13, 1984
Last certification
Nov 8, 2024
Beds
158 (150 certified)
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jun 6, 2013 in NJ
Enrollment address
425 Woodbury Turnersville Road
Northbrook Behavioral Health Hospital LLC
Blackwood, NJ 80122960
Other Hospital Practice Location
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Northbrook Behavioral Health HospitalCCN 314018 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1008869Northbrook Behavioral Health Hospital425 Woodbury Turnersville Road, Blackwood, NJ 08012Certificate of waiverJan 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Elmwood Hills Healthcare Center 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.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Manufacturers & Traders Trust Company Organization, Buffalo, NY Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Apr 30, 2014 95%
Simon Shain Individual W-2 Managing Employee May 15, 2016 75%
MDF Family 2015 Trust Organization, Lakewood, NJ 5% Or Greater Direct Ownership Interest Dec 28, 2016 15%
Deborah F Feigenbaum Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 34%
Avraham R Feigenbaum Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 34%
Avrohom Y Maierovits Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 8%
Zalman L Drew Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 20%

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1487070793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WOODBURY TURNERSVILLE RD",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WOODBURY TURNERSVILLE RD",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122960",
            "telephone_number": "856-374-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMWOOD HILLS HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "FEIGENBAUM",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-364-7100"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northbrook Behavioral Health Hospital LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blackwood, NJ

Sources for this page

Verify at the official NPI Registry.