NPIMap

Organization Active NPI

Serv Behavioral Health System, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Clifton, NJ
National Provider Identifier
1750424834
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
26NR10634000 Issued in NJ
Legal business name
SERV BEHAVIORAL HEALTH SYSTEM, INC.
Practice address
777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone
(973) 594-0125
Fax
(973) 534-0536
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Ms. Sandy Agresta, RN, BSN
Title
Nursing Service Coordinator
Phone
(973) 594-0125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 26NR10634000 NJ Primary

Addresses

Primary practice location

777 Bloomfield Ave
Clifton, NJ 07012-1242

Mailing address

777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone (973) 594-0125

National Provider Directory

National Provider Directory
Tax ID family
Serv Centers of New Jersey Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1750424834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121242",
            "telephone_number": "973-594-0125",
            "fax_number": "973-534-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121242",
            "telephone_number": "973-594-0125",
            "fax_number": "973-534-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERV BEHAVIORAL HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "AGRESTA",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "NURSING SERVICE COORDINATOR",
        "authorized_official_telephone_number": "973-594-0125",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NJ",
            "license": "26NR10634000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.