MARYVILLE INC NPI 1306346325

NPI Information

NPI: 1306346325
Provider Name: MARYVILLE, INC

Other Name: MARYVILLE ADDICTION TREATMENT CENTER

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
610 PEMBERTON BROWNS MILLS RD
PEMBERTON, NJ
ZIP 08068
Phone: (609) 321-6263
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MARYVILLE, INC is a substance abuse rehabilitation facility in Pemberton, NJ. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MARYVILLE, INC NPI is 1306346325. The provider is registered as an organization entity type.
The provider Other Name Is Maryville Addiction Treatment Center.

The provider's business location address is:

610 PEMBERTON BROWNS MILLS RD
PEMBERTON, NJ
ZIP 08068
Phone: (609) 321-6263
Fax: (609) 283-0262

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 2/16/2018 and was last updated on 8/1/2018.

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	324500000X	Substance Abuse Rehabilitation Facility		1000140	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	1000140	OTHER	NEW JERSEY	STATE OF NEW JERSEY OFFICE OF LICENSING

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: 11/14/2023

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