METRO EAST COMMUNITY CARE, LLC. (NPI# 1366090581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366090581 |
| Entity Type | Organization |
| Organization Name | METRO EAST COMMUNITY CARE, LLC. |
| Practice Address |
59 Main St Ste 206b West Orange NJ 07052-5333 |
| Practice Telephone | 6098373147 |
| Practice Fax Number | 9732734333 |
| Mailing Telephone | 6098373147 |
| Mailing Fax Number | 9732734333 |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | MR. DARRELL PETER SHOULARS (EXECUTIVE DIRECTOR/CEO) |
| Authorized Official Telephone | 6098373147 |
| Authorized Official Credential | M.A., M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| N | 251300000X | Local Education Agency (LEA) | Agencies | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10 N End Ter, Newark, NJ 071044404 | 8627043524 |
| Street Address |
59 MAIN ST STE 206B |
| City | WEST ORANGE |
| State | NJ |
| Zip Code | 07052-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134730278 | Robert Jason Lipka | Pharmacist | Eagle Rock Pharmacy, 470 Pleasant Valley Way, West Orange, NJ 07052 | 2020-08-12 |
| 1790317378 | Attain & Gain Counseling, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15 Ralph Road, West Orange, NJ 07052 | 2020-02-11 |
| 1508336140 | Total Family Solutions, LLC | Community/Behavioral Health | 80 Main Street Suite 410, West Orange, NJ 07052 | 2018-11-27 |
| 1639660202 | Valeria Ripa | Student in an Organized Health Care Education/Training Program | 141 Old Short Hills Rd Apt 7, West Orange, NJ 07052 | 2018-05-19 |
| 1316441967 | Ariel Yehdua Pedoeem | Student in an Organized Health Care Education/Training Program | 139 Riverside Drive, Binghamton, NY 07052 | 2018-03-20 |
| 1407367576 | Outpatient Usa | Neurological Surgery | 475 Prospect Avenue, Suite 110, West Orange, NJ 07052 | 2017-10-17 |
| 1962911578 | Anchor Behavioral Solutions LLC | Community/Behavioral Health | 59 Main St Ste 310, West Orange, NJ 07052 | 2017-09-26 |
| 1710400411 | Rohma Shaikh | Student in an Organized Health Care Education/Training Program | 115 Old Short Hills Road, Apt 570, West Orange, NJ 07052 | 2017-07-25 |
| 1326571811 | Celestina Enuma | Clinical Nurse Specialist | 200 Mt. Pleasant Ave. Apt O12, West Orange, NJ 07052 | 2017-04-11 |
| 1073065777 | Livia Derdova | Optometrist | 101 Old Short Hills Rd., Suite 430, West Orange, NJ 07052 | 2016-10-28 |
| Find all providers in zip 07052 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336140 | Total Family Solutions, LLC | Community/Behavioral Health | 80 Main Street Suite 410, West Orange, NJ 07052 | 2018-11-27 |
| 1194291690 | Amazing Supports LLC | Community/Behavioral Health | 59 Main St Ste 311, West Orange, NJ 07052-5333 | 2018-10-23 |
| 1962911578 | Anchor Behavioral Solutions LLC | Community/Behavioral Health | 59 Main St Ste 310, West Orange, NJ 07052 | 2017-09-26 |
| 1255789335 | Hope Therapeutic Services, LLC. | Community/Behavioral Health | 538 Mount Pleasant Ave, West Orange, NJ 07052-1404 | 2016-05-30 |
| 1487009452 | Inner Image Counseling & Consulting Services | Community/Behavioral Health | 90 Valley Way, West Orange, NJ 07052-5833 | 2016-04-27 |
| 1023477460 | Morgan Dream Foundation Inc. | Community/Behavioral Health | 68 William St, West Orange, NJ 07052-5721 | 2016-02-13 |
| 1396071668 | Positive Advancement Services | Community/Behavioral Health | 164 A Watson Avenue, West Orange, NJ 07052 | 2009-10-21 |
| 1952964611 | Archetype Psychological Services, LLC | Community/Behavioral Health | 444 Northfield Ave, West Orange, NJ 07052-3012 | 2019-04-18 |
| 1114453313 | Private Care Management and Consultation Services LLC | Community/Behavioral Health | 50 Northfield Ave, Ste 4, West Orange, NJ 07052-5320 | 2017-05-08 |
| 1538690029 | Community Advancement and Transformation | Community/Behavioral Health | 28 Maple Ave, West Orange, NJ 07052-2408 | 2017-03-25 |
| Find all providers in WEST ORANGE | ||||
| City | WEST ORANGE |
| Zip Code | 07052 |
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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.