AMBROSIA OF NEW JERSEY LLC (NPI# 1194298976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194298976 |
| Entity Type | Organization |
| Organization Name | AMBROSIA OF NEW JERSEY LLC |
| Practice Address |
287 Old Marlton Pike Medford NJ 08055-8761 |
| Mailing Address |
4821 Katella Ave Suite 111 Los Alamitos CA 90720 |
| Practice Telephone | 5615788600 |
| Mailing Telephone | 7148281800 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |
| Authorized Official Name | WILLIAM BRADLEY COOPER (CFO) |
| Authorized Official Telephone | 7149477351 |
| Is Organization Subpart | Y |
| Parent Organization Name | DISCOVERY PRACTICE MANAGEMENT, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Pinelands Recovery Center of Medford | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295139293 | Ambrosia of New Jersey LLC | Substance Abuse Rehabilitation Facility | 287 Old Marlton Pike, Medford, NJ 08055-8761 | 2014-10-20 |
| Street Address |
287 OLD MARLTON PIKE |
| City | MEDFORD |
| State | NJ |
| Zip Code | 08055-8761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404744 | Crystal Lee | Nurse Practitioner | 287 Old Marlton Pike, Medford, NJ 08055-8761 | 2020-07-16 |
| 1295139293 | Ambrosia of New Jersey LLC | Substance Abuse Rehabilitation Facility | 287 Old Marlton Pike, Medford, NJ 08055-8761 | 2014-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215406459 | Natalia Eltabaa | Nurse Practitioner | 143b Atsion Rd, Medford, NJ 08055 | 2018-11-16 |
| 1922574326 | Emily G Wilkins | Psychiatry & Neurology | 239 Taunton, A-2, Medford, NJ 08055 | 2018-10-23 |
| 1508348863 | Gerald D Mingin Jr. | Psychologist | 135 Eayrestown Rd. Suite A, Southampton, NJ 08055 | 2018-09-04 |
| 1316465750 | Gabriella Marie Francis | Specialist/Technologist | 133 Apache Trail, Medford Lakes, NJ 08055 | 2017-09-06 |
| 1265968572 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Eugenia, Medford, NJ 08055 | 2017-05-05 |
| 1326574690 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1503 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1780110007 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1610 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1902332216 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1909 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1083140396 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| 1457887762 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| Find all providers in zip 08055 | ||||
| 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 |
|---|---|---|---|---|
| 1770055428 | Ambrosia of Medford LLC | Substance Abuse Rehabilitation Facility | 283 Old Marlton Pike, Medford, NJ 08055-8761 | 2018-12-19 |
| 1730616020 | Ambrosia of Medford | Substance Abuse Rehabilitation Facility | 285 Old Marlton Pike, Medford, NJ 08055-8761 | 2017-05-17 |
| 1346282035 | Addictions Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 1003 East Main Street, Medford, OR 97504 | 2006-06-10 |
| 1295139293 | Ambrosia of New Jersey LLC | Substance Abuse Rehabilitation Facility | 287 Old Marlton Pike, Medford, NJ 08055-8761 | 2014-10-20 |
| 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 |
| 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.