Potential Uncharted

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

POTENTIAL UNCHARTED

Practice address

2 Arnot St Unit 455
Lodi, NJ 07644-1629

Phone

(914) 672-3973

NPI assigned

Mar 27, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Lee H Payne

Title

Co-Owner

Phone

(914) 672-3973

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648339200000",
    "number": "1679223176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ARNOT ST UNIT 455",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076441629",
            "telephone_number": "914-672-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ARNOT ST UNIT 455",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076441629",
            "telephone_number": "914-672-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENTIAL UNCHARTED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "914-672-3973",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Perez
• Donna Perillo, DC
• Philip M Dipasquale DC, PA
• Barbara Mary Pitocco, MSW
• Daniela Playa
• Patricia Procino
• Professional Occupational & Physical Therapy, PLLC
• Proper Care Physical Therapy Inc
• Anna Radisic, MD
• Maria Ann Ramos, MD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Lodi, NJ
• Providers in Lodi, NJ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2022; 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.