EXTRACARE HEALTH SERVICES (NPI# 1750435129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750435129 |
| Entity Type | Organization |
| Organization Name | EXTRACARE HEALTH SERVICES |
| Practice Address |
141 State Route 34 Matawan NJ 07747-2187 |
| Mailing Address |
141 State Route 34 P O Box 506 Matawan NJ 07747-2187 |
| Practice Telephone | 7327213835 |
| Practice Fax Number | 2394559027 |
| Mailing Telephone | 7327213835 |
| Mailing Fax Number | 2394559027 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN J KELLY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7327210060 |
| Authorized Official Credential | CSW, CDC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PSYD-2136 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
141 STATE ROUTE 34 |
| City | MATAWAN |
| State | NJ |
| Zip Code | 07747-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730730169 | Therapy Enlightens, LLC | Counselor | 811 Sloan Court, Matawan, NJ 07747 | 2019-09-26 |
| 1831748045 | Adam Fan | Physical Therapist | 1016 Hwy 34 Matawan, Building 9, Matawan, NJ 07747 | 2019-09-10 |
| 1255819843 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 96 Church St., Apt. 110, Aberdeen, NJ 07747 | 2018-08-06 |
| 1023547775 | Claire Casey | Counselor | 166 Main Strreet, Matawan, NJ 07747 | 2017-06-07 |
| 1174975361 | Danielle Barakat | Behavioral Analyst | 2 Mill Rd, Apt 2, Matawan, NJ 07747 | 2016-07-12 |
| 1275982019 | Angel Cardenas | Social Worker | 1208 Route 34 Tower 2 Suite 20, Aberdeen, NJ 07747 | 2016-06-10 |
| 1891175931 | Gabriella Taube | Dentist | 1130 Nj-34, Aberdeen Township, NJ 07747 | 2015-06-03 |
| 1639423874 | Bayshore Ems, Inc | Ambulance | 260 Church Street, Aberdeen, NJ 07747 | 2012-11-08 |
| 1689959462 | Michael Ruggiero | Counselor | 104 Wellington Place, Aberdeen, NJ 07747 | 2011-10-12 |
| 1619258407 | Maressa Nordstrom | Counselor | 196 Main St Ste 103, Matawan, NJ 07747 | 2011-09-07 |
| Find all providers in zip 07747 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962905711 | Denise M White | Psychologist | 30 Halstead St, Newark, NJ 07106-1102 | 2018-03-16 |
| 1598202863 | Cara Church, Phd LLC | Psychologist | 255 Shore Dr, #7, Highlands, NJ 07732-1568 | 2017-01-25 |
| 1396130712 | Faheem Mumin Nuruddin | Psychologist | 158 South Harrison Street #3g, East Orange, NJ 07018 | 2015-04-02 |
| 1508289224 | Bergen Psychiatric Associates | Psychologist | 294 State St Ste 2, Hackensack, NJ 07601-5515 | 2014-01-31 |
| 1720329576 | Jediedjah Moshe Rodrigues Pereira | Psychologist | 1212 Todd Ct, Lakewood, NJ 08701-2256 | 2013-03-04 |
| 1902166804 | Tracy Wrocklage | Psychologist | 500 Main St Bldg 2, Lanoka Harbor, NJ 08734-2228 | 2012-05-24 |
| 1245430545 | James William Langenbucher | Psychologist | 607 Allison Rd, Piscataway, NJ 08854-8001 | 2007-07-24 |
| 1255479077 | Henry Benvenisti | Psychologist | 48 N Middletown Road, Montvale, NJ 07645 | 2007-02-02 |
| 1598781973 | Bloomfield Health Pavilion LLC | Psychologist | 86 Bloomfield Ave, 1st Floor & Basement, Newark, NJ 07104-1905 | 2006-07-15 |
| 1366062101 | Miguel Mateo | Psychologist | 687 Frelinghuysen Ave, Newark, NJ 07114-1349 | 2020-04-22 |
| 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.