NPIMap

Organization Active NPI

Eva'S Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Paterson, NJ
National Provider Identifier
1811460165
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
EVA'S VILLAGE, INC.
Practice address
20 Jackson Street
Paterson, NJ 07501-2815
Phone
(973) 523-6220
Fax
(973) 825-7297
NPI assigned
Jan 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Vito Andrisani, LCADC
Title
Executive Vice President
Phone
(973) 523-6220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

20 Jackson Street
Paterson, NJ 07501-2815

Mailing address

393 Main St
Paterson, NJ 07501-2815
Phone (973) 523-6220

Other identifiers 1

IdentifierTypeStateIssuer
687359MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Eva'S Village Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1811460165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075012815",
            "telephone_number": "973-523-6220",
            "fax_number": "973-825-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 JACKSON STREET",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075012815",
            "telephone_number": "973-523-6220",
            "fax_number": "973-825-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVA'S VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "ANDRISANI",
        "authorized_official_first_name": "VITO",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "973-523-6220",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687359",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.