NPIMap

Organization Active NPI

Prime Healthcare Services - St. Mary'S Passaic, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Passaic, NJ
National Provider Identifier
1689093841
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PRIME HEALTHCARE SERVICES - ST. MARY'S PASSAIC, LLC
Practice address
530 Main Ave
Passaic, NJ 07055-5700
Phone
(973) 470-3168
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Troy A. Schell, ESQ.
Title
Secretary, General Counsel
Phone
(909) 235-4311

Specialties & licenses 1

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

Addresses

Primary practice location

530 Main Ave
Passaic, NJ 07055-5700

Mailing address

3300 E Guasti Rd
Third Floor
Ontario, CA 91761-8655
Phone (909) 235-4311

Other names 1

  • St. Mary's Hospital - Seton Comprehensive Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services -6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1689093841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E GUASTI RD",
            "address_2": "THIRD FLOOR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618655",
            "telephone_number": "909-235-4311",
            "fax_number": "909-235-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555700",
            "telephone_number": "973-470-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - ST. MARY'S PASSAIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "SCHELL",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SECRETARY, GENERAL COUNSEL",
        "authorized_official_telephone_number": "909-235-4311",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Hospital - Seton Comprehensive Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.