PENNREACH (NPI# 1790338119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790338119 |
| Entity Type | Organization |
| Organization Name | PENNREACH |
| Practice Address |
1482 Rahway Avenue 104 Woodbridge NJ 17001-0850 |
| Mailing Address |
18 S Main St Allentown NJ 08501-1610 |
| Practice Telephone | 2154095519 |
| Mailing Telephone | 2154095519 |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-07-24 |
| 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 |
| Other Name | Type Code |
|---|---|
| PennReach | Other Name - Individual/Organization |
| 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 |
| 1417502345 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Main St Apt 814, 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 |
| Street Address |
1482 RAHWAY AVENUE 104 |
| City | WOODBRIDGE |
| State | NJ |
| Zip Code | 17001-0850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740834068 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 227, Woodbridge, NJ 17001-0850 | 2019-07-25 |
| 1285288688 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt. 106, Woodbridge, NJ 17001 | 2019-07-25 |
| 1063066470 | Pennreach | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 114, Woodbridge, NJ 17001-0850 | 2019-07-25 |
| 1689227019 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 117, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1497308829 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 113, Woodbridge, NJ 08501-0850 | 2019-07-24 |
| 1285288613 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 119, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1932753373 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 203, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1649824087 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 204, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1134773583 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 212, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1750935102 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 116, Woodbridge, NJ 08501-0850 | 2019-07-24 |
| Find all providers in the same location | ||||
| 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 |
|---|---|---|---|---|
| 1891327417 | Perfect Home Support, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13662 Office Pl Ste 104, Woodbridge, VA 22192-4217 | 2020-02-11 |
| 1164076790 | Home Away Residential Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4304 Eldorado Dr, Woodbridge, VA 22193-2716 | 2019-07-31 |
| 1831755958 | Blessed Support Professionals, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14511 Jefferson Davis Hwy # A, Woodbridge, VA 22191-2807 | 2019-05-14 |
| 1588229306 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Ave, Apt 103, Woodbridge, NJ 07001 | 2019-05-07 |
| 1942800594 | E & E Residential Support Professionals LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15337 Barnabas Trl, Woodbridge, VA 22193-5566 | 2020-10-30 |
| 1871113936 | Applied Group Home Solutions LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1986 Opitz Blvd, Woodbridge, VA 22191-3304 | 2020-04-19 |
| 1740834068 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 227, Woodbridge, NJ 17001-0850 | 2019-07-25 |
| 1285288688 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt. 106, Woodbridge, NJ 17001 | 2019-07-25 |
| 1689227019 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 117, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1497308829 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 113, Woodbridge, NJ 08501-0850 | 2019-07-24 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 17001 |
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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.