NPIMap

Organization Active NPI

Preferred Behavioral Health of New Jersey, Inc.

  • Community/Behavioral Health Agency
  • Lakewood, NJ
National Provider Identifier
1801943717
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
20302-03-05A Issued in NJ
Legal business name
PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC.
Practice address
725 Airport Rd
Preferred Behavioral Health of NJ Interact Program
Lakewood, NJ 08701-5968
Phone
(732) 367-8859
Fax
(732) 367-8242
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Julie Vanore
Title
Cao
Phone
(732) 458-1700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 20302-03-05A NJ Primary
Community/Behavioral Health Agency 251S00000X 20302-03-05 NJ

Addresses

Primary practice location

725 Airport Rd
Preferred Behavioral Health of NJ Interact Program
Lakewood, NJ 08701-5968

Mailing address

PO Box 2036
Preferred Behavioral Health of New Jersey
Lakewood, NJ 08701-8036
Phone (732) 458-1700

Other identifiers 1

IdentifierTypeStateIssuer
5379105MedicaidNJ

Other names 1

  • Interact Program Other name

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

Other NPIs on the same Medicare enrollment 16

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

View all 16

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

Locations

725 Airport Rd
Lakewood, NJ 08701
Phone (732) 367-2665

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1801943717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "address_2": "PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087018036",
            "telephone_number": "732-458-1700",
            "fax_number": "732-785-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AIRPORT RD",
            "address_2": "PREFERRED BEHAVIORAL HEALTH OF NJ INTERACT PROGRAM",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015968",
            "telephone_number": "732-367-8859",
            "fax_number": "732-367-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "VANORE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "732-458-1700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "20302-03-05A",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "20302-03-05",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5379105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interact Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.