DUNGARVIN NEW JERSEY, LLC-DAWSON (NPI# 1013363779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013363779 |
| Entity Type | Organization |
| Organization Name | DUNGARVIN NEW JERSEY, LLC-DAWSON |
| Practice Address |
12 Dawson Rd Kendall Park NJ 08824 |
| Mailing Address |
1543 State Route 27 Suite 24 Somerset NJ 08873-4015 |
| Practice Telephone | 7322971532 |
| Mailing Telephone | 7324637227 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2018-07-13 |
| Authorized Official Name | MR. TIMOTHY MADDEN (CHAIRMAN OF THE BOARD & CEO) |
| Authorized Official Telephone | 6517895905 |
| Is Organization Subpart | Y |
| Parent Organization Name | DUNGARVIN GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0494275 | 05 |
| Street Address |
12 DAWSON RD |
| City | KENDALL PARK |
| State | NJ |
| Zip Code | 08824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496872 | Laura Funk | Physical Therapist | 3562 Route 27, Suite 124, Kendall Park, NJ 08824 | 2020-10-29 |
| 1639660178 | Megan Patterson, LLC | Social Worker | 3176 Nj Route 27, Suite 2b, Kendall Park, NJ 08824 | 2018-05-21 |
| 1073032363 | Mosaic Impex Inc | Occupational Therapy Assistant | 45 Hastings Road, Kendall Park, NJ 08824 | 2017-09-18 |
| 1497293708 | Nicholas Andrew Demetriou | Specialist/Technologist | 13 Dillon Road, Kendall Park, NJ 08824 | 2017-02-07 |
| 1780031054 | Community Options Enterprises, Inc | Day Training, Developmentally Disabled Services | 3330 Highway 27, Kendall Park, NJ 08824 | 2016-05-17 |
| 1538515390 | Dungarvin New Jersey, LLC-berwick | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Berwick Rd, Kendall Park, NJ 08824 | 2016-05-11 |
| 1912388471 | Dungarvin New Jersey, LLC-cranston | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 Cranston Rd, Kendall Park, NJ 08824 | 2015-06-10 |
| 1184017469 | Suk-ying Wang | Clinical Nurse Specialist | 3270 Route 27 Suite 1200, Kendall Park, NJ 08824 | 2015-03-11 |
| 1386980100 | Payal Shah | Pharmacist | 27 Villanova Drive, Kendall Park, NJ 08824 | 2012-12-26 |
| 1912242280 | Katrina Carter | Physical Therapist | 3562 Nj 27, Kendall Park, NJ 08824 | 2012-11-28 |
| Find all providers in zip 08824 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717644 | Premier Supports, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 New Rd, Kendall Park, NJ 08824-1132 | 2020-07-08 |
| 1316503287 | Premier Supports, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Cranston Rd, Kendall Park, NJ 08824-1115 | 2019-05-15 |
| 1922525955 | Dungarvin New Jersey, LLC - Stockton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18 Stockton Rd, Kendall Park, NJ 08824-1212 | 2017-08-30 |
| 1942726641 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24 Kingsley Rd, Kendall Park, NJ 08824-1147 | 2017-08-15 |
| 1669909479 | Everas Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 78 Stillwell Rd, Kendall Park, NJ 08824-1438 | 2017-05-11 |
| 1538515390 | Dungarvin New Jersey, LLC-berwick | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Berwick Rd, Kendall Park, NJ 08824 | 2016-05-11 |
| 1275903759 | Community Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 38 Constable Rd, Kendall Park, NJ 08824-1153 | 2015-09-28 |
| 1184094666 | Community Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 63 Henderson Rd, Kendall Park, NJ 08824-1506 | 2015-09-28 |
| 1467821827 | Community Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2 Aldrich Rd, Kendall Park, NJ 08824-1214 | 2015-09-16 |
| 1912388471 | Dungarvin New Jersey, LLC-cranston | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 Cranston Rd, Kendall Park, NJ 08824 | 2015-06-10 |
| Find all providers in KENDALL PARK | ||||
| City | KENDALL PARK |
| Zip Code | 08824 |
Please comment or provide details below to improve the information on DUNGARVIN NEW JERSEY, LLC-DAWSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.