PENNREACH (NPI# 1336767219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336767219 |
| Entity Type | Organization |
| Organization Name | PENNREACH |
| Practice Address |
111 Truman Square Apt 1208 Edison NJ 08817 |
| Mailing Address |
18 S Main St Allentown NJ 08501-1610 |
| Practice Telephone | 2154095519 |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |
| Authorized Official Name | KRYSTAL ODELL (CEO) |
| Authorized Official Telephone | 2154095519 |
| Is Organization Subpart | N |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525825 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1109, Edison, NJ 08817 | 2020-07-07 |
| 1841845690 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Waker Avenue, Allentown, NJ 08501-0850 | 2019-08-08 |
| 1144875071 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 810, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1053966986 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 812, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1417502345 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 814, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1376198275 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 910, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1245885185 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 912, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1497300354 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 914, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1326693284 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 1008, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1144875006 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 1010, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| Street Address |
111 TRUMAN SQUARE APT 1208 |
| City | EDISON |
| State | NJ |
| Zip Code | 08817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525825 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1109, Edison, NJ 08817 | 2020-07-07 |
| 1447867981 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1212, Edison, NJ 08817-0850 | 2020-09-29 |
| 1003425398 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1212, Edison, NJ 08817-0850 | 2020-07-23 |
| 1134747017 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1215, Edison, NJ 08817 | 2020-07-08 |
| 1952929838 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1213, Edison, NJ 08817 | 2020-07-08 |
| 1316565286 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1107, Edison, NJ 08817-0850 | 2020-07-08 |
| 1790303675 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1117, Edison, NJ 08817 | 2020-07-08 |
| 1154949030 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1114, Edison, NJ 08817 | 2020-07-08 |
| 1063030948 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1112, Edison, NJ 08817 | 2020-07-08 |
| 1881212769 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1116, Edison, NJ 08817 | 2020-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447862750 | Ling Zhu | Pharmacist | 2124 A State Route 27, Edison, NJ 08817 | 2020-08-18 |
| 1518582956 | Ismile Dental Care of Edison | Dentist | 1914 B Route 27, Edison, NJ 08817 | 2020-06-11 |
| 1437704905 | Ethel Diagnostic Laboratory | Pathology | 4 Ethel Road, Suite 402a, Edison, NJ 08817 | 2019-08-01 |
| 1316509250 | Hyun Sang Lee | Optometrist | 2210 Route 27 North, Edison, NJ 08817 | 2019-07-01 |
| 1578022851 | Labor of Love Healthcare LLC | Nursing Care | 1967 Lincoln Highway, Suite 33, Edison, NJ 08817 | 2019-03-18 |
| 1932664349 | Marlene Bott | Occupational Therapist | 2035 Lincoln Highway, Edison Square West, Edison, NJ 08817 | 2019-02-11 |
| 1174092928 | Neil Bakhru | Occupational Therapist | 802 Merrywood Drive, Edison, NJ 08817 | 2018-11-21 |
| 1164912697 | Milton Perez | Driver | 14m Reading Rd, Edison, NJ 08817 | 2018-05-10 |
| 1366931891 | Roseanna Perez | Recreation Therapist | 14m Reading Rd., Edison, NJ 08817 | 2018-05-10 |
| 1982126942 | Oasis Pharmacy LLC | Pharmacy | 237 Plainfield Avenue, Edison, NJ 08817 | 2017-07-12 |
| Find all providers in zip 08817 | ||||
| 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 |
|---|---|---|---|---|
| 1912525825 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Truman Square, Apt 1109, Edison, NJ 08817 | 2020-07-07 |
| 1760948681 | Janee Michele Lee | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1030 Grove Ave Apt 24g, Edison, NJ 08820-1537 | 2019-02-15 |
| 1386128569 | New Jersey Institute for Disabilities, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Edgemount Rd, Edison, NJ 08817-2904 | 2018-09-24 |
| 1164949079 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 43 Cambridge Rd, Edison, NJ 08817-3807 | 2017-08-23 |
| 1649796459 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12 Marie Ln, Edison, NJ 08817-4663 | 2017-08-15 |
| 1730605544 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 46 Roxy Ave, Edison, NJ 08820-1662 | 2017-08-15 |
| 1003338849 | Spectrum for Living Development, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1313 Waterford Dr, Edison, NJ 08817-1928 | 2017-07-13 |
| 1942722780 | Spectrum for Living Development, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1314 Waterford Dr, Edison, NJ 08817-1928 | 2017-07-13 |
| 1871015610 | Spectrum for Living Development, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 Waterford Dr, Edison, NJ 08817-1929 | 2017-07-13 |
| 1326560152 | Spectrum for Living Development, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1316 Waterford Dr, Edison, NJ 08817-1929 | 2017-07-13 |
| Find all providers in EDISON | ||||
Please comment or provide details below to improve the information on PENNREACH.
| 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.