Avenues to Independent Living

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

AVENUES TO INDEPENDENT LIVING

Practice address

304 S Broad St
Woodbury, NJ 08096-2404

Phone

(856) 537-7919

NPI assigned

Dec 12, 2012

Last updated

Jun 25, 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

Mrs. Joan C Clark

Title

Executive Director

Phone

(856) 537-7919

Specialties & licenses 4

Addresses

Tax ID family

Avenues to Independent Living2 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.

• Avenues to Independent Living

  • Developmentally Disabled Services Day Training Agency
  • Woodbury, NJ
  • NPI 1114363546
  NPD tax ID

Locations

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1699011049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962404",
            "telephone_number": "856-537-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962404",
            "telephone_number": "856-537-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUES TO INDEPENDENT LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-537-7919",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Avenues to Independent Living
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• Samantha Baney, MA, LAC
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• Developmentally Disabled Services Day Training Agency in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Developmentally Disabled Services Day Training Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.