NPIMap

Organization Active NPI

South Jersey Behavioral Health Resources, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Mount Ephraim, NJ
National Provider Identifier
1669991931
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
40301D050940 Issued in NJ
Legal business name
SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES, INC.
Practice address
406 Bell Rd
Mount Ephraim, NJ 08059-1709
Phone
(856) 312-4090
NPI assigned
Sep 18, 2017
Last updated
Sep 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Authorized official

Name
Theresa Wilson
Title
President/ Ceo
Phone
(856) 655-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 40301D050940 NJ Primary

Addresses

Primary practice location

406 Bell Rd
Mount Ephraim, NJ 08059-1709

Mailing address

2500 McClellan Ave Ste 300
Pennsauken, NJ 08109-0001
Phone (856) 361-1100

Other identifiers 1

IdentifierTypeStateIssuer
40301D050940OtherNJNJ DMHAS

National Provider Directory

National Provider Directory
Tax ID family
South Jersey Behavioral Health Resources Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1669991931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MCCLELLAN AVE STE 300",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081090001",
            "telephone_number": "856-361-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BELL RD",
            "city": "MOUNT EPHRAIM",
            "state": "NJ",
            "postal_code": "080591709",
            "telephone_number": "856-312-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY BEHAVIORAL HEALTH RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "856-655-1211"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NJ",
            "license": "40301D050940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ DMHAS",
            "identifier": "40301D050940",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Ephraim, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.