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ATLANTICARE HEALTH SERVICES INC. NPI 1215987771


NPI Information

NPI: 1215987771
Provider Name: ATLANTICARE HEALTH SERVICES, INC.

Other Name: ATLANTICARE HEALTH SERVICES - MISSION HEALTHCARE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 31D1030000

Address:
2009 BACHARACH BLVD
ATLANTIC CITY, NJ
ZIP 08401
Phone: (609) 344-5714
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ATLANTICARE HEALTH SERVICES, INC. is a clinic center in Atlantic City, NJ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ATLANTICARE HEALTH SERVICES, INC. NPI is 1215987771. The provider is registered as an organization entity type.
The provider Other Name Is Atlanticare Health Services - Mission Healthcare.

The provider's business location address is:

2009 BACHARACH BLVD
ATLANTIC CITY, NJ
ZIP 08401
Phone: (609) 344-5714
Fax: (609) 345-0775

The provider's authorized official is Sandy Festa .
The authorized official title is Executive Director Fqhc and has the following contact phone number (609) 572-6051.

The CLIA number assigned to this NPI record is 31D1030000 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 5/15/2018.


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
1261Q00000XClinic/Center23265NEW JERSEYYes

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
10028592MEDICAIDNEW JERSEY
231D103000OTHERNEW JERSEYCMS-CLIA
360019117OTHERNEW JERSEYHORIZON HEALTH HMO

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.