Victory Bay Recovery Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

VICTORY BAY RECOVERY CENTER, LLC

Practice address

1395 Chews Landing Road
Laurel Springs, NJ 08021

Phone

(856) 282-2050

Fax

(856) 352-6713

NPI assigned

Nov 15, 2016

Organization subpart

No

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

Authorized official

Name

Chris McGoldrick

Title

Director of Admission

Phone

(800) 253-0673

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Desimone

  • Professional Counselor
  • Laurel Springs, NJ
  • NPI 1346788676
  NPD (past)
• Leslie N Madrak, D.O.

  • Psychiatry Physician
  • Blackwood, NJ
  • NPI 1851363485
  NPD (past)
• Kelly Elisabeth Walker, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Laurel Springs, NJ
  • NPI 1316185259
  NPD (past)
• Heather Wilson, LCSW, LCADC, CCTP

  • Mental Health Counselor
  • Laurel Springs, NJ
  • NPI 1982232674
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1700328283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CHEWS LANDING ROAD",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "08021",
            "telephone_number": "856-282-2050",
            "fax_number": "856-352-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CHEWS LANDING ROAD",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "08021",
            "telephone_number": "856-282-2050",
            "fax_number": "856-352-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY BAY RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "MCGOLDRICK",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR OF ADMISSION",
        "authorized_official_telephone_number": "800-253-0673"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri-Town Dental Group, PA
• Robert M Vandertoorn
• Barbara Vassallo, APN
• Richard Denis Vecsi, D.D.S.
• Kim Mabel Vernon
• Kathleen Vitelliviscusi, RT
• Nguyet Vu-Nguyen, D.D.S
• Kelly Elisabeth Walker, RN
• Sharon A. Watson, PHARMD
• Heather Wilson, LCSW, LCADC, CCTP

• Substance Abuse Rehabilitation Facility in Laurel Springs, NJ
• Providers in Laurel Springs, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.