NPIMap

Organization Active NPI

Hendricks House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Egg Harbor City, NJ
National Provider Identifier
1982115903
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1000003 Issued in NJ
Legal business name
HENDRICKS HOUSE, INC.
Practice address
411 Aloe St
Egg Harbor City, NJ 08215-3559
Phone
(856) 794-2443
Fax
(856) 794-8887
NPI assigned
Oct 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Authorized official

Name
Judy Manno
Title
Assistant to the Director
Phone
(856) 794-2443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1000003 NJ Primary

Addresses

Primary practice location

411 Aloe St
Egg Harbor City, NJ 08215-3559

Mailing address

542 N West Blvd
Vineland, NJ 08360-2847
Phone (856) 794-2443

Other identifiers 1

IdentifierTypeStateIssuer
0055042MedicaidNJ

Other names 1

  • Hansen House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hendricks House Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

542 N West Blvd
Vineland, NJ 08360
Phone (856) 794-2443

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1982115903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 N WEST BLVD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083602847",
            "telephone_number": "856-794-2443",
            "fax_number": "856-794-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 ALOE ST",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082153559",
            "telephone_number": "856-794-2443",
            "fax_number": "856-794-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "MANNO",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "ASSISTANT TO THE DIRECTOR",
        "authorized_official_telephone_number": "856-794-2443"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NJ",
            "license": "1000003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055042",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hansen House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Egg Harbor City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.