SUMMIT BHC NEW JERSEY, LLC (NPI# 1174123582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174123582 |
| Entity Type | Organization |
| Organization Name | SUMMIT BHC NEW JERSEY, LLC |
| Practice Address |
133 Polk Ln Bridgeton NJ 08302-5905 |
| Mailing Address |
389 Nichol Mill Ln Ste 100 Franklin TN 37067-4887 |
| Practice Telephone | 8564557575 |
| Practice Fax Number | 8654531022 |
| Mailing Telephone | 8774633553 |
| Mailing Fax Number | 6154353725 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | MS. CHRISTY KELTNER (DIRECTOR OF CBO OPERATIONS) |
| Authorized Official Telephone | 6157164922 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Seabrook | Doing Business As Name - Organization |
| Street Address |
133 POLK LN |
| City | BRIDGETON |
| State | NJ |
| Zip Code | 08302-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588647143 | David P Russo | Internal Medicine | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2005-11-28 |
| 1942714464 | Kelly A Hoffman | Physician Assistant | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2017-11-20 |
| 1184993701 | Karen Lynn Kushner | Nurse Practitioner | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2011-12-28 |
| 1013210392 | Larena M Wilde | Counselor | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2010-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508390196 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Northwest Drive, Bridgeton, NJ 08302 | 2017-04-20 |
| 1124552716 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 198 Roadstown Road, Bridgeton, NJ 08302 | 2017-04-20 |
| 1861926453 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 555 Burlington Road, Bridgeton, NJ 08302 | 2017-04-20 |
| 1306370994 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 92 Princeton Avenue, Bridgeton, NJ 08302 | 2017-04-20 |
| 1205360245 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 50 Roberts Avenue, Bridgeton, NJ 08302 | 2017-04-17 |
| 1649704602 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 28 West Park Drive, Bridgeton, NJ 08302 | 2017-04-17 |
| 1871043299 | Leah Sadler | Counselor | 90 S Burlington Rd, 189, Bridgeton, NJ 08302 | 2016-10-10 |
| 1245695428 | Bkt High Quality Healthcare Agency LLC | Home Health | 6 South Laurel St., 2nd Floor, Bridgeton, NJ 08302 | 2015-12-15 |
| 1073986493 | Caringhouse Projects, Inc | Respite Care | 1040 Laurel Lane, Deerfield Township, NJ 08302 | 2015-11-06 |
| 1174903256 | Christopher Struby | Internal Medicine | 201 Laurel Heights Dr # 201, Bridgeton, NJ 08302 | 2015-06-04 |
| Find all providers in zip 08302 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184244691 | Seabrook House, Inc. | Substance Abuse Rehabilitation Facility | 223 Polk Ln, Bridgeton, NJ 08302-5904 | 2020-04-24 |
| 1063729499 | Faith Farm, Inc | Substance Abuse Rehabilitation Facility | 21 Stretch Rd, Bridgeton, NJ 08302-9260 | 2010-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051367 | Elev8 Centers of New Jersey | Substance Abuse Rehabilitation Facility | 20 Toler Pl, Newark, NJ 07114-1431 | 2020-10-21 |
| 1982218228 | New Pathway Counseling Services | Substance Abuse Rehabilitation Facility | 20 Powers Dr, Paramus, NJ 07652-2911 | 2020-09-03 |
| 1790308708 | John Brooks Recovery Center, A New Jersey Nonprofit Corporation | Substance Abuse Rehabilitation Facility | 1455 Pinewood Blvd, Mays Landing, NJ 08330 | 2020-05-26 |
| 1891318077 | The Shore Detox LLC | Substance Abuse Rehabilitation Facility | 30 W Jimmie Leeds Rd, Galloway, NJ 08205-9421 | 2020-05-22 |
| 1619598968 | Mountainside - Ramsey | Substance Abuse Rehabilitation Facility | 500 N Franklin Tpke Ste 304, Ramsey, NJ 07446-1160 | 2020-04-28 |
| 1922628502 | Seabrook House, Inc. | Substance Abuse Rehabilitation Facility | 101 Madison Ave Ste 205, Morristown, NJ 07960-7305 | 2020-04-23 |
| 1760002331 | Seabrook House, Inc. | Substance Abuse Rehabilitation Facility | 1930 Marlton Pike E Ste O77, Cherry Hill, NJ 08003-4204 | 2020-04-23 |
| 1396376018 | Cooper Center for Healing and Recovery, LLC | Substance Abuse Rehabilitation Facility | 761 Cuthbert Blvd, Cherry Hill, NJ 08002-3417 | 2020-01-31 |
| 1295395408 | Coleman Addiction Medicine, P.C. | Substance Abuse Rehabilitation Facility | 23-00 State Rt 208 Ste 1-1, Fair Lawn, NJ 07410-1558 | 2019-06-19 |
| 1588127443 | The Work Group | Substance Abuse Rehabilitation Facility | 3720 Marlton Pike, Pennsauken, NJ 08110-6311 | 2019-04-08 |
| Find all providers with the same taxonomy | ||||
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| 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.