NPIMap

Organization Active NPI

Unicorn Supportive Services

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Swedesboro, NJ
National Provider Identifier
1710400106
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
UNICORN SUPPORTIVE SERVICES
Practice address
22 Valley Forge Dr
Swedesboro, NJ 08085-4230
Phone
(856) 278-5188
NPI assigned
Jul 18, 2017
Last updated
Jul 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Authorized official

Name
Monday J Gabriel
Title
Administrator
Phone
(856) 278-5188

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X NJ
Custodial Care Facility 311Z00000X NJ
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NJ Primary
Physical Disabilities Residential Treatment Facility 320700000X NJ
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NJ

Addresses

Primary practice location

22 Valley Forge Dr
Swedesboro, NJ 08085-4230

Mailing address

22 Valley Forge Dr
Swedesboro, NJ 08085-4230

National Provider Directory

National Provider Directory
Tax ID family
Unicorn Supportive Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1710400106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 VALLEY FORGE DR",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080854230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 VALLEY FORGE DR",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080854230",
            "telephone_number": "856-278-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNICORN SUPPORTIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-21",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "MONDAY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "856-278-5188"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swedesboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.