MARYVILLE INC NPI 1205346574

NPI Information

NPI: 1205346574
Provider Name: MARYVILLE, INC
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Address: 1173 E LANDIS AVE
VINELAND, NJ
ZIP 08360
Phone: (856) 690-1000

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NPI Details

MARYVILLE, INC is a rehabilitation and substance use disorder clinic center in Vineland, NJ. MARYVILLE, INC NPI is 1205346574. The provider is registered as an organization entity type.

The provider's business location address is:

1173 E LANDIS AVE
VINELAND, NJ
ZIP 08360
Phone: (856) 690-1000
Fax: (856) 690-1764

The provider's authorized official is Jared Levy .
The authorized official title is Cfo and has the following contact phone number (856) 863-3913.

The enumeration date for this NPI number is 10/2/2017 and was last updated on 7/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	2000300	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0014818	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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