BANCROFT NEUROHEALTH (NPI# 1457887762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457887762 |
| Entity Type | Organization |
| Organization Name | BANCROFT NEUROHEALTH |
| Other Organization Name | BANCROFT-EUGENIA DR |
| Practice Address |
905 Eugenia Dr Medford NJ 08055 |
| Mailing Address |
1255 Caldwell Rd Cherry Hill NJ 08034-3220 |
| Practice Telephone | 8007745516 |
| Mailing Telephone | 8563481181 |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2017-05-05 |
| Authorized Official Name | JAMES P HARTMAN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8563481181 |
| 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 | TBI062 | NJ | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Bancroft-Eugenia Dr | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329336 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Villinger Ave, Cinnaminson, NJ 08077-2934 | 2020-09-03 |
| 1184232175 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 65 Brophy Ct, Ewing, NJ 08638-1224 | 2020-07-16 |
| 1891325908 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 347 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-01-17 |
| 1891335139 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 993 Shadow Oaks Dr, Toms River, NJ 08753-3531 | 2020-01-15 |
| 1134762065 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1703 Cedar Dr, Medford, NJ 08055-2322 | 2019-10-23 |
| 1932740883 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4104 Hamilton Dr, Voorhees, NJ 08043-3121 | 2019-10-02 |
| 1184187437 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3208 Avalon Ct, Voorhees, NJ 08043-4649 | 2019-04-12 |
| 1285194878 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1811 Kresson Rd, Cherry Hill, NJ 08003-2528 | 2019-03-21 |
| 1164998340 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 Eugenia Dr, Medford, NJ 08055-2312 | 2018-10-16 |
| 1972080059 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Hessian Way, Cherry Hill, NJ 08003-2615 | 2018-07-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BANCROFT NEUROHEALTH, A NEW JERSEY NONPROFIT CORPORATION | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 |
| Street Address |
905 EUGENIA DR |
| City | MEDFORD |
| State | NJ |
| Zip Code | 08055 |
| 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 |
| 1740716133 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1509 Cedar Dr, Medford, NJ 08055 | 2017-05-04 |
| Find all providers in zip 08055 | ||||
| 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 |
|---|---|---|---|---|
| 1134762065 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1703 Cedar Dr, Medford, NJ 08055-2322 | 2019-10-23 |
| 1164998340 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 Eugenia Dr, Medford, NJ 08055-2312 | 2018-10-16 |
| 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 |
| 1740716133 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1509 Cedar Dr, Medford, NJ 08055 | 2017-05-04 |
| 1831625227 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1701 Cedar Dr, Medford, NJ 08055 | 2017-05-04 |
| 1871029298 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 16 Oniontown Rd, Medford, NJ 08055 | 2017-05-04 |
| Find all providers in MEDFORD | ||||
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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.