NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bound Brook, NJ
National Provider Identifier
1841670809
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
GH2095 Issued in NJ
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
210 W Union Ave
Unit B
Bound Brook, NJ 08805-1335
Phone
(856) 241-3320
Fax
(856) 241-3321
NPI assigned
Jun 4, 2015
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Authorized official

Name
Darren Blough, M.S.W., BCABA
Title
State Director
Phone
(856) 241-3320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH2095 NJ Primary

Addresses

Primary practice location

210 W Union Ave
Unit B
Bound Brook, NJ 08805-1335

Mailing address

2520 Wrangle Hill Rd Ste 200
Bear, DE 19701-3856
Phone (302) 365-8050

Other identifiers 1

IdentifierTypeStateIssuer
0463591MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Advoserv of New Jersey Inc92 organizations share this tax ID, including this one
Part of
Advoserv of New Jersey Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1841670809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WRANGLE HILL RD STE 200",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013856",
            "telephone_number": "302-365-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W UNION AVE",
            "address_2": "UNIT B",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051335",
            "telephone_number": "856-241-3320",
            "fax_number": "856-241-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOSERV OF NEW JERSEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOSERV OF NEW JERSEY, INC.",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "BLOUGH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "STATE DIRECTOR",
        "authorized_official_telephone_number": "856-241-3320",
        "authorized_official_credential": "M.S.W., BCABA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "GH2095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bound Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.