VIVION LARRY BAMBARA NPI 1649857186

NPI Information

NPI: 1649857186
Provider Name: VIVION LARRY BAMBARA
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Individual
Address: 101 E GIBBSBORO RD APT 1611
LINDENWOLD, NJ
ZIP 08021
Phone: (346) 262-7732

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NPI Details

Vivion Larry Bambara is a community based residential treatment facility, intellectual and/or developmental disabilities in Lindenwold, NJ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Vivion Larry Bambara NPI is 1649857186. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 E GIBBSBORO RD APT 1611
LINDENWOLD, NJ
ZIP 08021-923
Phone: (346) 262-7732

The enumeration date for this NPI number is 3/29/2021 and was last updated on 1/1/2022.

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 State	Primary
1	251C00000X	Day Training, Developmentally Disabled Services			No
2	261QA0600X	Clinic/Center	Adult Day Care		No
3	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		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	1649857186	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: 3/30/2025

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