Rebuild Your Life LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1632435 Issued in NJ

Legal business name

REBUILD YOUR LIFE LLC

Practice address

488 Glassboro Rd
Suite 104, First Floor
Woodbury HTS, NJ 08097-1400

Phone

(856) 904-8888

Fax

(856) 853-0024

NPI assigned

Oct 27, 2011

Last updated

Oct 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen Oriti

Title

Owner

Phone

(856) 904-8888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1992081517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 GLASSBORO RD",
            "address_2": "SUITE 104, FIRST FLOOR",
            "city": "WOODBURY HTS",
            "state": "NJ",
            "postal_code": "080971400",
            "telephone_number": "856-904-8888",
            "fax_number": "856-853-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 GLASSBORO RD",
            "address_2": "SUITE 104, FIRST FLOOR",
            "city": "WOODBURY HTS",
            "state": "NJ",
            "postal_code": "080971400",
            "telephone_number": "856-904-8888",
            "fax_number": "856-853-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBUILD YOUR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "ORITI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-904-8888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "1632435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Home Healthcare
• Melissa L Mills, CRNP
• Scott R Schafer, LPC LMFT

• Community/Behavioral Health Agency in Woodbury HTS, NJ
• Providers in Woodbury HTS, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.