Monte Nido New Jersey LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MONTE NIDO NEW JERSEY LLC

Doing business as

Clementine Cherry Hill

Practice address

120 Munn LN
Cherry Hill, NJ 08034-3030

Phone

(856) 626-5100

Fax

(856) 428-1629

NPI assigned

Sep 22, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Mike Bagley

Title

Chief Financial Officer

Phone

(305) 663-1876

Specialties & licenses 1

Addresses

Other names 1

• Clementine Cherry Hill Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Monte Nido 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.

• Monte Nido New Jersey LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parsippany, NJ
  • NPI 1942088539
  NPD tax ID
• Monte Nido New Jersey LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Skillman, NJ
  • NPI 1942090212
  NPD tax ID

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1902529076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH STREET",
            "address_2": "MONTE NIDO AFFILIATES",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "305-663-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MUNN LN",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343030",
            "telephone_number": "856-626-5100",
            "fax_number": "856-428-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE NIDO NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-663-1876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clementine Cherry Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shamika Monday, RN
• Kimberly Monico, COTA
• Justin Jude Monisit
• Kim Montagano, BCBA
• Rebeca E Montanero, M.A., BCBA
• Juvy M Montecalvo-Acosta, NP
• Amelia Jae Montgomery
• Catherine P Montgomery, M.D.
• David Quinn Montgomery
• Isabelle Montoya, BCBA

• Adolescent and Children Mental Health Clinic/Center in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.