NPIMap

Organization Active NPI

Montclair Hospital LLC

Doing business as Psych Unit

  • Psychiatric Hospital Unit
  • Montclair, NJ
National Provider Identifier
1841444718
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MONTCLAIR HOSPITAL LLC
Doing business as
Psych Unit
Practice address
1 Bay Ave
Montclair, NJ 07042-4837
Phone
(973) 429-6451
NPI assigned
Nov 5, 2008
Last updated
Jun 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Joe Johnson
Title
Vice President
Phone
(866) 465-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

1 Bay Ave
Montclair, NJ 07042-4837

Mailing address

1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000

Other identifiers 1

IdentifierTypeStateIssuer
0135038MedicaidNJ

Other names 1

  • Psych Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210525002424 NJ Part A Provider - Hospital 7810092814 1 other NPI on this enrollment
Practice locations: Montclair, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841444718. Details of each certification follow.

Hospital certification: CCN 31S054

Legal name
MONTCLAIR HOSPITAL LLC
Doing business as
HACKENSACK MERIDIAN HEALTH, MOUNTAINSIDE MEDICAL CENTER
Organization structure
LLCProprietary
Enrollment address
1 Bay Ave
Hackensack Umc Mountainside
Montclair, NJ 70424837
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
LHP Montclair LLC Organization, Plano, TX Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2012 80%
Ardent Health Inc Organization, Nashville, TN Corporation 5% Or Greater Indirect Ownership Interest Mar 13, 2017 80%
Joseph Alan Deschryver Individual Corporate Director Jan 1, 2026
W-2 Managing EmployeeAd; Jan 1, 2026 100%
Mary a Crabtree Individual Corporate OfficerSVP and Treasurer Mar 13, 2017
LHP Operations Co LLC Organization, Plano, TX LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2012 80%
Montclair Health System LLC Organization, Plano, TX Corporation 5% Or Greater Direct Ownership Interest Feb 20, 2014
LHP Hospital Group, Inc. Organization, Plano, TX Corporation 5% Or Greater Direct Ownership Interest Feb 20, 2014
Stephen C Petrovich Individual Corporate OfficerEvp General Counsel Mar 13, 2017
HMH Hospitals Corporation Organization, Hackensack, NJ 5% Or Greater Direct Ownership Interest Feb 20, 2014
Ardent Legacy Holdings LLC Organization, Nashville, TN LLC 5% Or Greater Indirect Ownership Interest Mar 13, 2017 80%
Ahp Health Partners, Inc Organization, Nashville, TN LLC 5% Or Greater Indirect Ownership Interest Mar 13, 2017 80%

Owners & managing parties with NPI records 22

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 22

Facilities with the same owner 64

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 64

Practitioners & affiliated clinicians

Practitioners 4

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": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1841444718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000",
            "fax_number": "973-429-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "866-465-9222"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135038",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psych Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.