NPIMap

Organization Active NPI

State of New Jersey Omb Centralized Payroll

Doing business as Woodbine Developmental Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Woodbine, NJ
National Provider Identifier
1982642641
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Doing business as
Woodbine Developmental Center
Practice address
1175 Dehirsch Ave
Woodbine, NJ 08270-2401
Phone
(609) 861-2164
Fax
(609) 861-5176
NPI assigned
Jun 3, 2006
Last updated
Jan 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Authorized official

Name
Mr. Robert J Armstrong, RN, BSN, MSA
Title
Ceo
Phone
(609) 861-6041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

1175 Dehirsch Ave
Woodbine, NJ 08270-2401

Mailing address

1175 Dehirsch Ave
Woodbine, NJ 08270-2401
Phone (609) 861-2164

Other identifiers 2

IdentifierTypeStateIssuer
4472004MedicaidNJ
528582OtherNJPROVIDER GROUP

Other names 1

  • Woodbine Developmental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050420000657 NJ Part B Supplier - Clinic/Group Practice 6406742592 Receives reassigned benefits from 11 practitioners
Practice locations: Woodbine, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982642641. Details of each certification follow.

  • CCN 31G004 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 31G004

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WOODBINE DEVELOPMENTAL CENTER
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 16, 1977
Last certification
Feb 19, 2025
Beds
270
Ownership / control type
State
Facility address
1175 Dehirsch Ave
Woodbine, NJ 08270

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2194546Woodbine Developmental Center1175 Dehirsch Ave, Woodbine, NJ 08270Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hunterdon Development C22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
New Jersey Veterans Memorial Home at ParamusParamus, NJ, CCN 315346 Skilled nursing facility Operational/Managerial Control
Other		 Jul 1, 1995
Jul 1, 1995

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1982642641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 DEHIRSCH AVE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "082702401",
            "telephone_number": "609-861-2164",
            "fax_number": "609-861-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 DEHIRSCH AVE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "082702401",
            "telephone_number": "609-861-2164",
            "fax_number": "609-861-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-861-6041",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, BSN, MSA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4472004",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER GROUP",
            "identifier": "528582",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodbine Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbine, NJ

Sources for this page

Verify at the official NPI Registry.