BONNIE BRAE NPI 1780291542

NPI Information

  • NPI: 1780291542
  • Provider Name: BONNIE BRAE
  • Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
  • Specialization: Substance Abuse Treatment, Children
  • Entity Type: Organization
  • Address: 3415 VALLEY ROAD
    LIBERTY CORNER, NJ
    ZIP 07938
  • Phone: (908) 647-0800

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NPI Details

BONNIE BRAE is a substance abuse treatment and children substance abuse rehabilitation facility in Liberty Corner, NJ. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. BONNIE BRAE NPI is 1780291542. The provider is registered as an organization entity type.

The provider's business location address is:

3415 VALLEY ROAD
LIBERTY CORNER, NJ
ZIP 07938
Phone: (908) 647-0800
Fax: (908) 647-5021

The provider's authorized official is Paul D. Rieger .
The authorized official title is Ceo and has the following contact phone number (908) 647-4719.

The enumeration date for this NPI number is 9/25/2020 and was last updated on 9/25/2020.

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
1323P00000XPsychiatric Residential Treatment FacilityNo
23245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

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
11831522523MEDICAIDNEW JERSEY
21245689686MEDICAIDNEW JERSEY
31912063702MEDICAIDNEW JERSEY
41497152961MEDICAIDNEW JERSEY
51003081605MEDICAIDNEW JERSEY
61447885520MEDICAIDNEW JERSEY
71235405689MEDICAIDNEW JERSEY
81508220922MEDICAIDNEW JERSEY
9183448414MEDICAIDNEW 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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