Healthcare Provider Details

I. General information

NPI: 1154870160
Provider Name (Legal Business Name): JOHN BROOKS RECOVERY CENTER , A NEW JERSEY NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 BLACK HORSE PIKE
PLEASANTVILLE NJ
08232
US

IV. Provider business mailing address

660 BLACK HORSE PIKE
PLEASANTVILLE NJ
08232
US

V. Phone/Fax

Practice location:
  • Phone: 609-345-2020
  • Fax: 609-646-7027
Mailing address:
  • Phone: 609-345-2020
  • Fax: 609-646-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT SZAPOR
Title or Position: AVP
Credential:
Phone: 609-569-7869