NPIMap

Organization Active NPI

Advoserv of New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Swedesboro, NJ
National Provider Identifier
1841721602
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
AT3085 Issued in NJ
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
104 Richardson Ave
Swedesboro, NJ 08085-1149
Phone
(856) 241-3320
Fax
(856) 241-3321
NPI assigned
Mar 23, 2017
Last updated
Mar 23, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOSERV OF NEW JERSEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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 AT3085 NJ Primary

Addresses

Primary practice location

104 Richardson Ave
Swedesboro, NJ 08085-1149

Mailing address

510 Heron Dr Ste 114
Swedesboro, NJ 08085-1767
Phone (856) 241-3320

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 22

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

View all 22

Locations

104 Richardson Ave
Swedesboro, NJ 08085

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1841721602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HERON DR STE 114",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851767",
            "telephone_number": "856-241-3320",
            "fax_number": "856-241-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 RICHARDSON AVE",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851149",
            "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": "2017-03-23",
        "last_updated": "2017-03-23",
        "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": "AT3085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swedesboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.