Pathways to Serenity, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

37LC00187200 Issued in NJ

Legal business name

PATHWAYS TO SERENITY, LLC

Practice address

500 Main St Ste 2
Suite 1
Lanoka Harbor, NJ 08734-2228

Phone

(609) 242-9500

Fax

(609) 242-9502

NPI assigned

Aug 8, 2016

Organization subpart

No

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

Authorized official

Name

Anthony B. Riccobono, LCADC

Title

Owner/Operator

Phone

(609) 242-9500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1841744869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MAIN ST STE 2",
            "address_2": "SUITE 1",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "609-242-9500",
            "fax_number": "609-242-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAIN ST STE 2",
            "address_2": "SUITE 1",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "609-242-9500",
            "fax_number": "609-242-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS TO SERENITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "RICCOBONO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "609-242-9500",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": "37LC00187200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Lanoka Harbor, NJ
• Providers in Lanoka Harbor, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.