NPIMap

Organization Active NPI

Maryville, Inc.

  • Substance Abuse Rehabilitation Facility
  • Williamstown, NJ
National Provider Identifier
1801018361
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
80850 Issued in NJ
Legal business name
MARYVILLE, INC.
Practice address
1903 Grant Ave
Williamstown, NJ 08094
Phone
(856) 629-0244
Fax
(856) 629-0799
NPI assigned
May 3, 2007
Last updated
Aug 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Mr. Jared Levy
Title
Cfo
Phone
(856) 863-3913

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 80850 NJ Primary

Addresses

Primary practice location

1903 Grant Ave
Williamstown, NJ 08094

Mailing address

1903 Grant Ave
Williamstown, NJ 08094-6139
Phone (856) 629-0244

Other identifiers 1

IdentifierTypeStateIssuer
7602804MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Maryville Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1801018361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 GRANT AVE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080946139",
            "telephone_number": "856-629-0244",
            "fax_number": "856-629-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 GRANT AVE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "08094",
            "telephone_number": "856-629-0244",
            "fax_number": "856-629-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-863-3913",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NJ",
            "license": "80850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7602804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.