RECOVERY CENTERS OF AMERICA AT VENTNOR NJ MEDICAID ONLY (NPI# 1154858520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154858520 |
| Entity Type | Organization |
| Organization Name | RECOVERY CENTERS OF AMERICA AT VENTNOR NJ MEDICAID ONLY |
| Other Organization Name | RECOVERY CENTERS OF AMERICA AT VENTNOR |
| Practice Address |
2701 Renaissance Boulevard 4th Floor King of Prussia PA 19406 |
| Mailing Address |
6601 Ventnor Avenue Ventnor Professional Building T Suite Ventnor City NJ 08406 |
| Practice Telephone | 6109942968 |
| Mailing Telephone | 6109942968 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2019-02-04 |
| NPI Deactivation Date | 04/24/2018 |
| NPI Reactivation Date | 2019-02-04 |
| Authorized Official Name | MARK GALLIHUE (CORPORATE DIRECTOR, PATIENT ACCOUNT) |
| Authorized Official Telephone | 6109942968 |
| Is Organization Subpart | Y |
| Parent Organization Name | TRC-OC LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Recovery Centers of America at Ventnor | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2701 Renaissance Boulevard, 4th Floor, King of Prussia, PA 19406 | 6109942968 |
| Street Address |
2701 RENAISSANCE BOULEVARD 4TH FLOOR |
| City | KING OF PRUSSIA |
| State | PA |
| Zip Code | 19406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366979494 | Recovery Centers of America At Manahawkin Nj Medicaid Only | Clinic/Center | 2701 Renaissance Boulevard, 4th Floor, King of Prussia, PA 19406 | 2017-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346887296 | Optical World Nj Corp | Optometrist | Optical World, 160 N. Gulph Rd King of Prussia Plaza Suite #2377, King of Prussia, PA 19406 | 2019-12-10 |
| 1194213694 | Compass Recovery Center | Clinic/Center | 901 E 8th Ave Ste 203, King of Prussia, PA 19406 | 2018-04-30 |
| 1568913192 | Luke Gillespie | Counselor | 680 American Avenue, Suite 320, King of Prussia, PA 19406 | 2016-10-19 |
| 1932652906 | Bayada Home Health Care, Inc. | Home Health | 700 American Ave Ste 103, King of Prussia, PA 19406 | 2016-07-26 |
| 1912357690 | Barsha Moktan | Dentist | 357 S Gulph Road, #110, King of Prussia, PA 19406 | 2016-06-14 |
| 1588057756 | National Counseling Group, Inc | Counselor | 1150 1st Avenue, #501, King of Prussia, PA 19406 | 2015-03-12 |
| 1184020174 | Dr. Jeanvickey Lusk, M.d. & Co. P.C. | Family Medicine | 315 Gypsy Lane, King of Prussia, PA 19406 | 2014-11-18 |
| 1912303033 | Masuma Bahora | Obstetrics & Gynecology | 210 Mall Blvd Ste 220, King of Prussia, PA 19406 | 2014-11-17 |
| 1942612486 | Delphi Medical Group | Durable Medical Equipment & Medical Supplies | 1600 First Avenue Ste 400, King of Prussia, PA 19406 | 2014-06-02 |
| 1306268347 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 160 N Gulph Rd # 2007a, King of Prussia, PA 19406 | 2014-01-10 |
| Find all providers in zip 19406 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992232029 | Recovery Centers of America At Voorhees Nj Medicaid Only | Clinic/Center | 2701 Renaissance Blvd Fl 4, King of Prussia, PA 19406-2781 | 2017-05-19 |
| 1366979494 | Recovery Centers of America At Manahawkin Nj Medicaid Only | Clinic/Center | 2701 Renaissance Boulevard, 4th Floor, King of Prussia, PA 19406 | 2017-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816204 | Source Behavioral Health Services, LLC | Clinic/Center | 301 Oxford Valley Rd Ste 1302, Yardley, PA 19067-7706 | 2020-06-22 |
| 1780218594 | Davis Archway Centers for Addiction Treatment, Inc. | Clinic/Center | 114 Courson Ln, Emlenton, PA 16373-2502 | 2020-03-02 |
| 1871125625 | New Hope Community Medical Care LLC | Clinic/Center | 2602 W 9th St Ste 101, Chester, PA 19013-2089 | 2020-02-10 |
| 1528699931 | Caron Outpatient Services, LLC | Clinic/Center | 401 Plymouth Rd Ste 325, Plymouth Meeting, PA 19462-1650 | 2020-02-04 |
| 1124658331 | White Oak Wellness | Clinic/Center | 1966 Lincoln Way Ste 100, White Oak, PA 15131-2416 | 2020-01-16 |
| 1518517283 | Peace Valley Recovery | Clinic/Center | 5230 York Rd, Doylestown, PA 18902-1736 | 2019-09-16 |
| 1841853256 | Trinity Recovery LLP | Clinic/Center | 1311 E State St, Sharon, PA 16146-3246 | 2019-04-22 |
| 1861950909 | Advanced Treatment Centers LLC | Clinic/Center | 60 Abele Rd Ste 1103, Bridgeville, PA 15017-3467 | 2019-03-07 |
| 1467918722 | Melissa Francomacaro | Clinic/Center | 1035 W Walnut St Apt 2, Allentown, PA 18102-4847 | 2019-02-12 |
| 1205390325 | Pyramid Health Care Inc. | Clinic/Center | 100 Upper Demunds Rd, Dallas, PA 18612-8811 | 2019-01-23 |
| Find all providers with the same taxonomy | ||||
| City | KING OF PRUSSIA |
| Zip Code | 19406 |
Please comment or provide details below to improve the information on RECOVERY CENTERS OF AMERICA AT VENTNOR NJ MEDICAID ONLY.
| 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.