State of New Jersey Omb Centralized Payroll

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL

Practice address

169 Minnisink Rd
Totowa, NJ 07512-1803

Phone

(973) 256-1700

Fax

(973) 256-7651

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Werkheiser

Title

Ceo

Phone

(973) 890-4540

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• North Jersey Developmental Center Doing business as

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1922046903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 169",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075110169",
            "telephone_number": "973-256-1700",
            "fax_number": "973-256-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MINNISINK RD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121803",
            "telephone_number": "973-256-1700",
            "fax_number": "973-256-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "WERKHEISER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-890-4540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BILLING GROUP NO",
            "identifier": "528584",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4497601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Jersey Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Totowa, NJ
• Providers in Totowa, NJ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.