PENNREACH


Address: 43 Park Boulevard, Clementon, NJ 08021
Phone: 7329634523

PENNREACH (NPI# 1871007286) 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) 1871007286
Entity Type Organization
Organization Name PENNREACH
Practice Address 43 Park Boulevard
Clementon
NJ 08021
Mailing Address 18 S Main St
Allentown
NJ 08501-1610
Practice Telephone 7329634523
Practice Fax Number 6092594120
Mailing Telephone 7329634523
Mailing Fax Number 6092594120
Enumeration Date 2017-11-21
Last Update Date 2017-11-21
Authorized Official Name PAULINE BAILO (DIRECTOR)
Authorized Official Telephone 2154752401
Is Organization Subpart N

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 IDs and Locations

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

Office Location

Street Address 43 PARK BOULEVARD
City CLEMENTON
State NJ
Zip Code 08021

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124663059 Harmony Bay Wellness, LLC Clinic/Center 1387 Chews Landing Road, Laurel Springs, NJ 08021 2019-11-14
1134782576 Mobile Dental Care of Delaware Pa Dentist 239 Cypress Ave, Lindenwold, NJ 08021 2019-04-22
1316441645 Ability Advocates of New Jersey Case Management 1451 Chews Landing Rd, Suite 208, Clementon, NJ 08021 2018-03-21
1639697444 Oaks Integrated Care Clinic/Center 1611 Hinder La, Clemmenton, NJ 08021 2017-08-31
1548785462 Poonam Yadav Dentist 3, Kelly Drivers Ln, Laurel Springs, NJ 08021 2017-08-11
1669996468 Arc of Camden County - Heather Sa Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1990 Laurel Road, Apt Ac-248, Lindenwold, NJ 08021 2017-08-02
1881118610 Arc of Camden County- Millbridge Supported Living Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 285 Millhurst Ct, Apt 258, Clementon, NJ 08021 2017-08-02
1710409982 Leavy Healthcare Services, Inc. Non-emergency Medical Transport (VAN) 906 Mason Run, Pine Hill, NJ 08021 2017-07-10
1982134599 Achieving A Better Life Case Management 1600 Laurel Road, E66, Lindenwold, NJ 08021 2017-06-15
1568997245 Bancroft Neurohealth Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 127 Florence Ave, Laurel Springs, NJ 08021 2017-05-01
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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
1447752365 21 Plus, Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 9 Stoney Bridge Rd, Clementon, NJ 08021-2706 2018-03-07
1215447040 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 700, Clementon, NJ 08021-5656 2017-10-06
1821508649 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 708, Clementon, NJ 08021-5656 2017-10-06
1770093502 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 710, Clementon, NJ 08021-5656 2017-10-06
1437669264 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 713, Clementon, NJ 08021-5656 2017-10-06
1700396538 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 714, Clementon, NJ 08021-5656 2017-10-06
1285144006 Kelsch Associates Inc. New Jersey Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1801 Broadacres Dr Apt 715, Clementon, NJ 08021-5656 2017-10-06
1881118610 Arc of Camden County- Millbridge Supported Living Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 285 Millhurst Ct, Apt 258, Clementon, NJ 08021 2017-08-02
1417481011 The Devereux Foundation Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 47 Windmill Court, Clementon, NJ 08021 2017-04-20
1164956769 The Devereux Foundation Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 224 Godshalk Avenue, Clementon, NJ 08021 2017-04-20
Find all providers in CLEMENTON

Competitor

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City CLEMENTON
Zip Code 08021

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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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