Organization Active NPI

Bonnie Brae

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Liberty Corner, NJ
National Provider Identifier
1508220922
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
BONNIE BRAE
Practice address
3415 Valley Road
Liberty Corner, NJ 07938-0825
Phone
(908) 647-0800
Fax
(908) 647-5021
NPI assigned
Apr 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
Mr. William M. Powers, MHA, MPA
Title
Chief Executive Officer
Phone
(908) 647-0800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

3415 Valley Road
Liberty Corner, NJ 07938-0825

Mailing address

PO Box 825
Liberty Corner, NJ 07938-0825
Phone (908) 647-0800

National Provider Directory

National Provider Directory
Tax ID family
Bonnie Brae13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1508220922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825",
            "city": "LIBERTY CORNER",
            "state": "NJ",
            "postal_code": "079380825",
            "telephone_number": "908-647-0800",
            "fax_number": "908-647-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 VALLEY ROAD",
            "city": "LIBERTY CORNER",
            "state": "NJ",
            "postal_code": "079380825",
            "telephone_number": "908-647-0800",
            "fax_number": "908-647-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE BRAE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "908-647-0800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA, MPA"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Corner, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.