DUNGARVIN NEW JERSEY, LLC-PARK


Address: 19 Park Ave, Beverly, NJ 08010
Phone: 6097477892

DUNGARVIN NEW JERSEY, LLC-PARK (NPI# 1528418209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528418209
Entity Type Organization
Organization Name DUNGARVIN NEW JERSEY, LLC-PARK
Practice Address 19 Park Ave
Beverly
NJ 08010
Mailing Address 1543 State Route 27
Suite 24
Somerset
NJ 08873-4015
Practice Telephone 6097477892
Mailing Telephone 7324637227
Enumeration Date 2016-06-14
Last Update Date 2018-07-13
Authorized Official Name MR. TIMOTHY MADDEN (CHAIRMAN OF THE BOARD & CEO)
Authorized Official Telephone 6517895905
Is Organization Subpart Y
Parent Organization Name DUNGARVIN GROUP, INC.

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NJ 0494275 05

Office Location

Street Address 19 PARK AVE
City BEVERLY
State NJ
Zip Code 08010

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285014365 National Mentor Healthcare, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 216 Laurel St, Beverly, NJ 08010-1226 2015-06-04

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1003413311 Excelsior Services Group LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 415 Main Ave, Wood Ridge, NJ 07075-2055 2020-10-08
1659988178 Community Options, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 19 Heather Ln, Belle Mead, NJ 08502-5125 2020-09-29
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Competitor

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City BEVERLY
Zip Code 08010

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Dataset Information

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.

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