MARYVILLE, INC (NPI# 1306346325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306346325 |
Entity Type | Organization |
Organization Name | MARYVILLE, INC |
Other Organization Name | MARYVILLE ADDICTION TREATMENT CENTER |
Practice Address |
610 Pemberton Browns Mills Rd Pemberton NJ 08068 |
Mailing Address |
129 Johnson Rd Ste 7 Turnersville NJ 08012-1777 |
Practice Telephone | 6093216263 |
Practice Fax Number | 6092830262 |
Mailing Telephone | 8568633913 |
Enumeration Date | 2018-02-16 |
Last Update Date | 2018-08-01 |
Authorized Official Name | MR. JARED LEVY (CFO) |
Authorized Official Telephone | 8568633913 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | 1000140 | NJ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NJ | STATE OF NEW JERSEY OFFICE OF LICENSING | 1000140 | 01 |
Other Name | Type Code |
---|---|
MARYVILLE ADDICTION TREATMENT CENTER | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205346574 | Maryville, Inc | Clinic/Center | 1173 E Landis Ave, Vineland, NJ 08360 | 2017-10-02 |
1225262629 | Maryville, Inc | Clinic/Center | 129 Johnson Rd Ste 7, Turnersville, NJ 08012 | 2009-05-13 |
1619474780 | Maryville, Inc | Clinic/Center | 1907 New Rd, Northfield, NJ 08225 | 2018-04-06 |
1437655594 | Maryville, Inc | Clinic/Center | 1907 New Rd, Northfield, NJ 08225 | 2018-04-05 |
1457851107 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2018-02-20 |
1073023354 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 1903 Grant Ave, Williamstown, NJ 08094 | 2017-10-02 |
1922518299 | Maryville, Inc | Clinic/Center | 129 Johnson Rd Ste 7, Turnersville, NJ 08012-1777 | 2017-10-02 |
1780806083 | Maryville, Inc | Clinic/Center | 707 N Main St, Glassboro, NJ 08028-1605 | 2007-05-03 |
Street Address |
610 PEMBERTON BROWNS MILLS RD |
City | PEMBERTON |
State | NJ |
Zip Code | 08068 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154643500 | Phyllis Glenn Anderson | Nurse Practitioner | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2010-02-25 |
1710593579 | Jeana Ann Simko | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2020-09-17 |
1457851107 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2018-02-20 |
1396128955 | Legacy Treatment Services | Clinic/Center | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-07-01 |
1881085637 | Legacy Treatment Services | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-02-16 |
1962800367 | Orin H Morrison Jr. | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-12-17 |
1790180438 | Kevin Ford | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-10-23 |
1376944967 | Union Association of The Children's Home of Burlington County, Inc. | Clinic/Center | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-09-15 |
1881093920 | Union Assocation of The Children's Home of Burlington County, Inc. | Community/Behavioral Health | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-08-14 |
1902180037 | The Kintock Group of New Jersey, Inc. | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2011-10-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366998502 | Deena Gutch | Counselor | 610 Brownsmills Rd, Pemberton, NJ 08068 | 2016-08-28 |
1467738492 | Exceptional Kidz Rehabilitation | Counselor | 43 Elizabeth St, Pemberton, NJ 08068 | 2011-10-21 |
1972716603 | Ellen Christine Miller | Occupational Therapy Assistant | 600 Pemberton Browns-mills Road, Pemberton, NJ 08068 | 2007-05-08 |
1720236631 | Renuka Maringanti | Dentist | 600 Pemberton Browns Mills Rd, Pemberton, NJ 08068 | 2008-09-04 |
1053453076 | Chitra Sarvotam | Dentist | 600 Pemberton-browns Mills Road, Pemberton, NJ 08068 | 2007-02-13 |
1700182847 | E Estrella Wells | Student in an Organized Health Care Education/Training Program | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2011-02-08 |
1417339128 | Jamie Reuter | Behavioral Analyst | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2015-06-18 |
1710167614 | Stephen Alan Kloss | Pharmacist | 87 Hanover St, Pemberton, NJ 08068-1131 | 2007-11-07 |
1639291248 | Pemberton Township School District | Local Education Agency (LEA) | 1 Egbert St, Pemberton, NJ 08068-1211 | 2007-04-04 |
1851635791 | Aspired Living, Inc | Day Training, Developmentally Disabled Services | 43 Elizabeth St, Pemberton, NJ 08068-1215 | 2012-11-15 |
Find all providers in zip 08068 |
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 |
---|---|---|---|---|
1457851107 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2018-02-20 |
1881085637 | Legacy Treatment Services | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-02-16 |
1902180037 | The Kintock Group of New Jersey, Inc. | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2011-10-07 |
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 |
1184244691 | Seabrook House, Inc. | Substance Abuse Rehabilitation Facility | 223 Polk Ln, Bridgeton, NJ 08302-5904 | 2020-04-24 |
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 |
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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.