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STATELINE MEDICAL
NPI 1316468945
Clinic/Center - Methadone in Phillipsburg, NJ

Active since July 05, 2017CLIA 31D2132661 · Waiver
590 MARSHALL ST, PHILLIPSBURG, NJ 08865(908) 387-0003 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 26, 2022, Jun 16, 2018, Jul 5, 2017 (3 updates tracked since 2017).

About Stateline Medical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STATELINE MEDICAL (NPI 1316468945) is a healthcare organization registered as a methadone in Phillipsburg, New Jersey and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through June 25, 2027 and lists Robyn Tanis, Executive Director Of Contract Mgmt, as its authorized official.

NPPES Registry Identity

NPI1316468945
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NamePINNACLE TREATMENT CENTERS NJ-II LLC
Location Address590 MARSHALL STPhillipsburg, NJ 08865-2629
Mailing Address1317 Route 73 Ste 200Mount Laurel, NJ 08054-2202 · (856) 439-6111
Phone(908) 387-0003
Organization SubpartYesParent: Pinnacle Treatment Centers, Inc.
Authorized OfficialRobyn TanisExecutive Director Of Contract Mgmt · (856) 533-8762
Enumeration DateJuly 5, 2017
Last NPPES UpdateApril 26, 20223 updates tracked since enumeration
NPPES CertifiedApril 26, 2022
✔ NPI 1316468945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
590 MARSHALL ST, Phillipsburg, NJ 08865
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Other Names 1

Doing Business AsStateline Medical

Other Identifiers 1

Medicaid0159774NJ

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2132661

Pinnacle Treatment Centers Nj-Ii, LLC Stateline Medical · Phillipsburg, NJ
Active · expires Jun 25, 2027
CLIA Number31D2132661
Laboratory TypeAlcohol & Drug Treatment
Certificate Effective DateJune 26, 2025
Certificate Expiration DateJune 25, 2027
Laboratory DirectorChristopher K. Johnston
Laboratory Phone(908) 387-0003
Laboratory LocationPinnacle Treatment Centers Nj-Ii, LLC Stateline Medical590 Marshall Street, Phillipsburg, NJ 08865
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LATISHA S. FREDERICK
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
BROOKE HOCKING
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
MRS. AMANDA J MUSCHETT
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
ANTHONY MIDDLE MORELLI JR.
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
JANICE WRIGHT LCADC
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
WARREN MEDICAL SERVICES, INC.
Clinic/Center (Methadone)
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0003
SCOTT POHL CPRS
Counselor (Addiction (Substance Use Disorder))
590 MARSHALL ST
PHILLIPSBURG, NJ 08865
Warren County (908) 387-0004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pinnacle Treatment Centers Nj-Ii LLC's NPI number?

The NPI number for Pinnacle Treatment Centers Nj-Ii LLC is 1316468945. It was assigned to this organization in the NPPES registry on July 5, 2017. The provider is doing business as Stateline Medical.

Where is Pinnacle Treatment Centers Nj-Ii LLC located?

Pinnacle Treatment Centers Nj-Ii LLC is located at 590 Marshall St, Phillipsburg, NJ 08865. The listed phone number is (908) 387-0003.

What is Pinnacle Treatment Centers Nj-Ii LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Pinnacle Treatment Centers Nj-Ii LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2132661) is associated with this NPI, valid through June 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pinnacle Treatment Centers Nj-Ii LLC was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.