NPIMap

Organization Active NPI

Preferred Behavioral Health of New Jersey, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Eatontown, NJ
National Provider Identifier
1780118869
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC.
Practice address
40 Christopher Way
Eatontown, NJ 07724-3327
Phone
(732) 663-1800
NPI assigned
Apr 17, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Julie Vanore
Title
Coo
Phone
(732) 458-1700

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Practitioners 5

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050629000660 NJ Part B Supplier - Clinic/Group Practice 3971414533 Receives reassigned benefits from 51 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toms River, NJ; Lakewood, NJ; Eatontown, NJ; Brick, NJ; Barnegat, NJ

National Provider Directory

National Provider Directory
Tax ID family
Preferred Behavioral Health of New Jersey25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2000648 NJ
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

NPPES NPI Registry

Primary practice location

40 Christopher Way
Eatontown, NJ 07724-3327

Mailing address

PO Box 2036
Lakewood, NJ 08701-8036
Phone (732) 458-1700

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2000648OtherNJNJ LICENSE
0576328MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 3, 2023.

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1780118869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087018036",
            "telephone_number": "732-458-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CHRISTOPHER WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243327",
            "telephone_number": "732-663-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "VANORE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-458-1700"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "2000648",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "2000648",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0576328",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.