PACIFIC LIGHT RECOVERY CENTER (NPI# 1295223147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295223147 |
| Entity Type | Organization |
| Organization Name | PACIFIC LIGHT RECOVERY CENTER |
| Practice Address |
811 Church Rd Cherry Hill NJ 08002-1412 |
| Mailing Address |
304 Arcadia Ct Jackson NJ 08527-2296 |
| Practice Telephone | 9172509323 |
| Mailing Telephone | 9172509323 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |
| Authorized Official Name | SALVATORE J. JOHNSON (CEO) |
| Authorized Official Telephone | 9172509323 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
811 CHURCH RD |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08002-1412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700901618 | Valerie A Travis | Counselor | 811 Church Rd, Suite 137, Cherry Hill, NJ 08002-1412 | 2007-03-20 |
| 1164957601 | Hope | Community/Behavioral Health | 811 Church Rd, Cherry Hill, NJ 08002-1412 | 2017-04-21 |
| 1659806271 | Crystal Ann Harms | Assistant Behavior Analyst | 811 Church Rd, Cherry Hill, NJ 08002-1412 | 2017-04-21 |
| 1487001764 | Lindsey Katherine Gallagher | Behavioral Analyst | 811 Church Rd, Cherry Hill, NJ 08002-1412 | 2016-05-17 |
| 1972918076 | Dignity Care LLP | In Home Supportive Care | 811 Church Rd, Cherry Hill, NJ 08002-1412 | 2014-06-26 |
| 1659797876 | Amanda Goodwin | Dietitian, Registered | 811 Church Rd, Cherry Hill, NJ 08002-1412 | 2014-03-12 |
| 1407103641 | Miracles of The Mind, LLC | Marriage & Family Therapist | 811 Church Rd, Suite 137, Cherry Hill, NJ 08002-1412 | 2012-08-07 |
| 1811133127 | Attentive Care Inc | In Home Supportive Care | 811 Church Rd, Suite 215, Cherry Hill, NJ 08002-1412 | 2008-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649878547 | Rachel J Crutchley | Behavioral Analyst | 923 Haddonfield Road Suite 300, Cherry Hill, NJ 08002 | 2020-10-13 |
| 1356954713 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 650 Garden Park Blvd, Cherry Hill, NJ 08002 | 2020-08-26 |
| 1104483825 | Advocare, LLC | Specialist | 600 West Marlton Pike, Suite C, Cherry Hill, NJ 08002 | 2019-05-29 |
| 1881155299 | Tyesha Thomas | Counselor | 57 Colwick Drive, Suite 120, Cherry Hill, NJ 08002 | 2019-03-28 |
| 1982184479 | Brian Keith Smalls Jr. | Early Intervention Provider Agency | 1701 Bishop View Circle, Cherry Hill, NJ 08002 | 2018-08-15 |
| 1124510094 | Salvatore Montana Messina | Student in an Organized Health Care Education/Training Program | 2250 Chapel Avenue, Suite 100, Cherry Hill, NJ 08002 | 2018-06-05 |
| 1871010397 | Jocelyn Lea Daigle | Counselor | 2201 Chapel Avenue W, Cherry Hill, NJ 08002 | 2017-08-25 |
| 1225559495 | Kennedy Medical Group Practice P.C. | Dietitian, Registered | 2211 Chapel Avenue West, Suite 301, Cherry Hill, NJ 08002 | 2017-06-28 |
| 1245750926 | Casey Rich | Behavioral Analyst | 923 Haddonfield Rd Ste 300, Cherry Hill, NJ 08002 | 2017-06-22 |
| 1790211514 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Nevada Ave, Cherry Hill, NJ 08002 | 2017-05-11 |
| Find all providers in zip 08002 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
| 1437764354 | Phoenix Behavioral Health LLC | Clinic/Center | 102 Browning Ln Ste 2, Cherry Hill, NJ 08003-3195 | 2020-09-09 |
| 1134636582 | Life of Purpose Nj, LLC | Clinic/Center | 2 Executive Campus 2370 Nj-70, Cherry Hill, NJ 08002-4102 | 2018-01-08 |
| 1073070900 | Phoenix Behavioral Health LLC | Clinic/Center | 102 Browning Ln Ste C3, Cherry Hill, NJ 08003-3195 | 2019-02-27 |
| 1841430337 | The Foundation for Family Guidance | Clinic/Center | 1871 Route 70 E, Suite 202, Cherry Hill, NJ 08003-2020 | 2009-02-24 |
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| 1710504881 | Vimax LLC | Clinic/Center | 6 Cornwall Ct, East Brunswick, NJ 08816-3347 | 2020-07-06 |
| 1588289615 | Camden County Suboxone LLC | Clinic/Center | 8 Somerdale Sq, Somerdale, NJ 08083-1345 | 2020-06-15 |
| 1558905380 | Grace Community Development Center | Clinic/Center | 100 Melville Ln, Willingboro, NJ 08046-2912 | 2019-11-05 |
| 1740822121 | The Empowerment House, Non Profit Inc. | Clinic/Center | 1314 S Clinton Ave, Trenton, NJ 08611-1436 | 2019-10-17 |
| 1265088892 | Absolute Awakenings Treatment Center LLC | Clinic/Center | 3000 Route 10 West, Denville, NJ 07834 | 2019-08-09 |
| 1326607243 | Recovery Zone Solutions, LLC | Clinic/Center | 124 East Main Street, Ste#109, Denville, NJ 07834 | 2019-06-13 |
| 1720644800 | Ars Treatment Centers of New Jersey, PC | Clinic/Center | 4 Murray Grove Ln, Lanoka Harbor, NJ 08734-2837 | 2019-05-14 |
| 1184182230 | Turning Point, Inc. | Clinic/Center | 101 Prospect St Ste 210, Lakewood, NJ 08701-5003 | 2019-03-07 |
| 1811460165 | Eva's Village, Inc. | Clinic/Center | 20 Jackson Street, Paterson, NJ 07501-2815 | 2019-01-09 |
| Find all providers with the same taxonomy | ||||
| City | CHERRY HILL |
| Zip Code | 08002 |
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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.