Organization · Type 2 NPI

Ambrosia of New Jersey LLC

Substance Abuse Rehabilitation Facility · Medford, NJ

NPI number 1194298976 Active

Practice location

287 Old Marlton Pike
Medford, NJ 08055-8761

Call (561) 578-8600 Map

Mailing address

4821 Katella Ave, Suite 111
Los Alamitos, CA 90720

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: 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.

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NPI record

NPI: 1194298976
Entity type: Organization (Type 2)
Issued: Jan 4, 2019
Last updated: Jan 4, 2019
Status: Active
Subpart: Yes of Discovery Practice Management, Inc

Other names

Pinelands Recovery Center of Medford · doing business as

Authorized official

William Bradley Cooper
CFO
(714) 947-7351

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1194298976

Ambrosia of New Jersey LLC's National Provider Identifier is 1194298976, issued on Jan 4, 2019. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Medford, NJ. The record was last updated on Jan 4, 2019.