Wiley Christian Adult Day Services, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

080473 Issued in NJ

Legal business name

WILEY CHRISTIAN ADULT DAY SERVICES, INC.

Practice address

6103 Westfield Ave
Pennsauken, NJ 08110-1754

Phone

(856) 486-9737

Fax

(856) 486-1098

NPI assigned

Oct 28, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gary F Gilmore

Title

Ceo

Phone

(856) 983-0411

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Wiley Christian Adult Day Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Wiley Christian Adult Day Services Inc

  • Adult Mental Health Clinic/Center
  • Pennsauken, NJ
  • NPI 1932238151
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicolle Deluca, LPC

  • Mental Health Counselor
  • Pennsauken, NJ
  • NPI 1487472809
  NPD (past)

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528059656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E MAIN ST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532122",
            "telephone_number": "856-983-0411",
            "fax_number": "856-985-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6103 WESTFIELD AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101754",
            "telephone_number": "856-486-9737",
            "fax_number": "856-486-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY CHRISTIAN ADULT DAY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-983-0411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NJ",
            "license": "080473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012122",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Walsh
• Kathleen R. Walters, RN
• Warren B. Mangel, DPM
• Emily Westerfield, CRPS
• Wiley Christian Adult Day Services Inc
• Ronald Collins Williams
• Barbara Wilson, RD
• Debra Elizabeth Wilson
• Harvey Wolbransky, OD
• Fallon Nicole Woodford

• Adult Day Care Clinic/Center in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Adult Day Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.