St. Timothy's Group Home for Boys

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

ST. TIMOTHY'S GROUP HOME FOR BOYS

Practice address

25 James St
Newark, NJ 07102-2001

Phone

(973) 621-2273

Fax

(973) 621-7259

NPI assigned

May 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judy D. Bennett

Title

Deputy Executive Director

Phone

(973) 621-2273

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Cross Counter Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cross Counter, Inc

  • Community/Behavioral Health Agency
  • Orange, NJ
  • NPI 1124201462
  NPD tax ID

Locations

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689883498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 HEYWOOD AVE",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070502006",
            "telephone_number": "973-673-4562",
            "fax_number": "973-673-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JAMES ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022001",
            "telephone_number": "973-621-2273",
            "fax_number": "973-621-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. TIMOTHY'S GROUP HOME FOR BOYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DEPUTY EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-621-2273"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8488509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St Michaels Cardiology Associates
• St Peter Pharmacy
• Dustin St. George, MD
• St. James Social Services Corp.
• St. Therese Ministry and Sabbath School
• Vasley St.Juste
• Rhea Deborah Stadtmauer
• Alex Stewart Stagnaro-Green, M.D.
• Benjamin David Stamler, MD
• Paulette Denise Stanford, MD

• Emotionally Disturbed Childrens' Residential Treatment Facility in Newark, NJ
• Providers in Newark, NJ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Jersey

• 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.