Healthcare Provider Details

I. General information

NPI: 1659085645
Provider Name (Legal Business Name): JOHN BROOKS RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 PINEWOOD BLVD
MAYS LANDING NJ
08330-2068
US

IV. Provider business mailing address

1455 PINEWOOD BLVD
MAYS LANDING NJ
08330-2068
US

V. Phone/Fax

Practice location:
  • Phone: 609-345-2020
  • Fax:
Mailing address:
  • Phone: 609-345-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SHARON D SNELLBAKER
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 609-457-0467