NPIMap

Organization Active NPI

The Open Door of New Jersey

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Brick, NJ
National Provider Identifier
1639723968
Registry record updated Apr 29, 2021
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
THE OPEN DOOR OF NEW JERSEY
Practice address
175 Chambers Bridge Rd Apt 142
Brick, NJ 08723-3504
Phone
(732) 408-5681
NPI assigned
Jul 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Nicole Hall
Title
Director of Services
Phone
(732) 408-5681

Specialties & licenses 1

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

Addresses

Primary practice location

175 Chambers Bridge Rd Apt 142
Brick, NJ 08723-3504

Mailing address

1658 Lakewood Rd Ste 12
Toms River, NJ 08755-1280
Phone (732) 408-5681

Other identifiers 1

IdentifierTypeStateIssuer
0477389MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
The Open Door of New Jersey10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1639723968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 LAKEWOOD RD STE 12",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551280",
            "telephone_number": "732-408-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CHAMBERS BRIDGE RD APT 142",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087233504",
            "telephone_number": "732-408-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPEN DOOR OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES",
        "authorized_official_telephone_number": "732-408-5681"
    },
    "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": "0477389",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.