NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Pennsville, NJ
National Provider Identifier
1578055216
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
2 S Hook Rd
Pennsville, NJ 08070-2359
Phone
(856) 241-3320
NPI assigned
May 30, 2018
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Authorized official

Name
Michael Wilder, MHSA
Title
Senior VP of Operations
Phone
(856) 241-3320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

2 S Hook Rd
Pennsville, NJ 08070-2359

Mailing address

510 Heron Dr Ste 114
Swedesboro, NJ 08085-1767

Other identifiers 1

IdentifierTypeStateIssuer
0463591MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Advoserv of New Jersey Inc92 organizations share this tax ID, including this one
Part of
Advoserv of New Jersey Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1578055216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HERON DR STE 114",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S HOOK RD",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702359",
            "telephone_number": "856-241-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOSERV OF NEW JERSEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOSERV OF NEW JERSEY, INC.",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SENIOR VP OF OPERATIONS",
        "authorized_official_telephone_number": "856-241-3320",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.