NPIMap

Organization Active NPI

Kennedy Health Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sewell, NJ
National Provider Identifier
1578817755
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
KENNEDY HEALTH SYSTEMS
Practice address
454 Hurffville Crosskeys Rd
Sewell, NJ 08080-2339
Phone
(856) 582-1419
Fax
(856) 582-7661
NPI assigned
Nov 9, 2012
Last updated
Nov 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Mr. Russell Micoli
Title
Coporate Director
Phone
(856) 488-6734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NJ Primary

Addresses

Primary practice location

454 Hurffville Crosskeys Rd
Sewell, NJ 08080-2339

Mailing address

454 Hurffville Crosskeys Rd
Sewell, NJ 08080-2339
Phone (856) 582-1419

National Provider Directory

National Provider Directory
Tax ID family
Mark a Demasi DO15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1578817755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 HURFFVILLE CROSSKEYS RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802339",
            "telephone_number": "856-582-1419",
            "fax_number": "856-582-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 HURFFVILLE CROSSKEYS RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802339",
            "telephone_number": "856-582-1419",
            "fax_number": "856-582-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "MICOLI",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "COPORATE DIRECTOR",
        "authorized_official_telephone_number": "856-488-6734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.