Theracare of New Jersey LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THERACARE OF NEW JERSEY LLC

Practice address

67 Walnut Ave
Suite 306
Clark, NJ 07066-1640

Phone

(888) 311-2611

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Calderon

Title

President

Phone

(212) 564-2350

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Theracare of New Jersey LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Theracare of New Jersey LLC

  • Community/Behavioral Health Agency
  • Clark, NJ
  • NPI 1174669626
  NPD tax ID
• Theracare of New Jersey LLC

  • Community/Behavioral Health Agency
  • Pennsauken, NJ
  • NPI 1679619126
  NPD tax ID

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1881731958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE",
            "address_2": "SUITE 306",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "888-311-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE",
            "address_2": "SUITE 306",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "888-311-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERACARE OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-564-2350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020192",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Counseling Center at Clark NJ, LLC
• The Eye Center of Clark
• The Hearing Center, PC
• Theracare Managed Services, LLC
• Theracare of New Jersey LLC
• Harry A. Thibodeau, R.PH.
• Thomas a. Kowalenko, D.O.
• Benia Thomas, LCSW
• Jennifer Thomson, MD
• Corrin Tota

• Community/Behavioral Health Agency in Clark, NJ
• Providers in Clark, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.