PENNREACH (NPI# 1417502345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417502345 |
| Entity Type | Organization |
| Organization Name | PENNREACH |
| Practice Address |
69 Main St Apt 814 Fort Lee NJ 07024-6909 |
| Mailing Address |
18 S Main St Allentown NJ 08501-1610 |
| Practice Telephone | 2154095519 |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |
| 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 |
| 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 |
| 1770138638 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 1108, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| Street Address |
69 MAIN ST APT 814 |
| City | FORT LEE |
| State | NJ |
| Zip Code | 07024-6909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828726 | You S Jung | Pharmacist | 1275 15th Street Apt 2e, Fort Lee, NJ 07024 | 2020-07-17 |
| 1205316528 | Professional Orthopedic and Sports Therapy of Nj, LLC | Physical Therapist | 2200 Fletcher Ave Ste 505, Fort Lee, NJ 07024 | 2018-08-16 |
| 1194210138 | Hyunjoo Lee | Pharmacy | 168 Fletcher Ave, Fort Lee, NJ 07024 | 2018-06-22 |
| 1912423724 | Fort Lee Health Supplies | Durable Medical Equipment & Medical Supplies | 96 Linwood Plaza Rte 9 W, Fort Lee, NJ 07024 | 2017-08-15 |
| 1669997482 | Jinseok Woo | Acupuncturist | 6 Horizon Rd., Apt 2504, Fort Lee, NJ 07024 | 2017-08-14 |
| 1578083705 | Sheran Rey | Licensed Vocational Nurse | 6308 Hilltop Ct, Fort Lee, NJ 07024 | 2017-06-20 |
| 1558812909 | Jian Cui | Acupuncturist | 500 Linwood Drive Apt3c, Fort Lee, NJ 07024 | 2016-10-20 |
| 1013392919 | Yulong Yang | Internal Medicine | 2083 Center Ave Ste 2a, Fort Lee, NJ 07024 | 2015-07-22 |
| 1235561796 | Anthony Lucev | Student in an Organized Health Care Education/Training Program | 233 Harmon Ave, Fort Lee, NJ 07024 | 2013-08-06 |
| 1811331598 | Bridgeview Rehabilitation and Medical Arts Center | Physical Medicine & Rehabilitation | 454 Main Street 3rd Floor, Fort Lee, NJ 07024 | 2013-04-24 |
| Find all providers in zip 07024 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1770138638 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 1108, Fort Lee, NJ 07024-6909 | 2019-08-07 |
| 1538714878 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 610, Fort Lee, NJ 07024-6909 | 2019-08-05 |
| 1174178412 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 612, Fort Lee, NJ 07024-6909 | 2019-08-05 |
| Find all providers in FORT LEE | ||||
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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.