NPIMap

Organization Active NPI

Serv Centers of New Jersey, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Cranford, NJ
National Provider Identifier
1629130729
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
4040 Issued in NJ
Legal business name
SERV CENTERS OF NEW JERSEY, INC
Practice address
111 North Avenue West
Cranford, NJ 07016
Phone
(908) 276-3359
Fax
(609) 276-2472
NPI assigned
Dec 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gary Van Nostrand
Title
Ceo
Phone
(609) 406-0100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 4040 NJ Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 50004X42Y207 NJ
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 50004X42Y307 NJ

Addresses

Primary practice location

111 North Avenue West
Cranford, NJ 07016

Mailing address

380 Scotch Rd
W Trenton, NJ 08628
Phone (609) 406-0100

Other identifiers 1

IdentifierTypeStateIssuer
8535906MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Serv Centers of New Jersey Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

111 North Ave W
Cranford, NJ 07016
Phone (908) 276-3359

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629130729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SCOTCH RD",
            "city": "W TRENTON",
            "state": "NJ",
            "postal_code": "08628",
            "telephone_number": "609-406-0100",
            "fax_number": "609-406-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTH AVENUE WEST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "07016",
            "telephone_number": "908-276-3359",
            "fax_number": "609-276-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERV CENTERS OF NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN NOSTRAND",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-406-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NJ",
            "license": "4040",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NJ",
            "license": "50004X42Y207",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NJ",
            "license": "50004X42Y307",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8535906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranford, NJ

Sources for this page

  • 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.