NPIMap

Organization Active NPI

Community Quest Woodbine

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Woodbine, NJ
National Provider Identifier
1942862719
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
COMMUNITY QUEST WOODBINE
Practice address
1449 Dehirsch Ave Apt 1
Woodbine, NJ 08270-2454
Phone
(609) 861-3044
NPI assigned
Jul 2, 2019
Last updated
Jul 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY QUEST WOODBINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Kerrie Jean Kelly
Title
Cfo
Phone
(609) 646-0388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

1449 Dehirsch Ave Apt 1
Woodbine, NJ 08270-2454

Mailing address

6814 Tilton Rd
Egg Harbor Township, NJ 08234-4490
Phone (609) 646-0388

Other identifiers 1

IdentifierTypeStateIssuer
0487694MedicaidNJ

Other names 1

  • Community Quest, Inc Other name

National Provider Directory

National Provider Directory
Tax ID family
Communtity Quest Cornell17 organizations share this tax ID, including this one
Part of
Communtity Quest Cornell

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1942862719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6814 TILTON RD",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082344490",
            "telephone_number": "609-646-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 DEHIRSCH AVE APT 1",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "082702454",
            "telephone_number": "609-861-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY QUEST WOODBINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY QUEST WOODBINE",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KERRIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "609-646-0388"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487694",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Quest, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woodbine, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.