BONNIE BRAE RESIDENTIAL TREATMENT CENTER - NPI 1912063702 - Residential Treatment Facility, Emotionally Disturbed Children in Liberty Corner, NJ

Q: What is Bonnie Brae's NPI number?

The NPI number for Bonnie Brae is 1912063702. It was assigned to this organization in the NPPES registry on December 28, 2006. The provider is also known as Bonnie Brae Residential Treatment Center.

Q: What is Bonnie Brae's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Q: When was this NPI record last updated?

The NPPES record for Bonnie Brae was last updated on July 21, 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.

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About Bonnie Brae Residential Treatment Center NPPES

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

BONNIE BRAE RESIDENTIAL TREATMENT CENTER (NPI 1912063702) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Liberty Corner, New Jersey and active in the NPI registry since December 2006. The organization lists William M. Powers, Ceo, as its authorized official.

NPPES Registry Identity

NPI1912063702

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameBONNIE BRAE

Location Address3415 VALLEY ROADLiberty Corner, NJ 07938

Mailing Address3415 Valley Road, Po Box 825Liberty Corner, NJ 07938 · (908) 647-0800 · Fax (908) 647-5021

Phone(908) 647-0800

Fax(908) 647-5021

Organization SubpartNo

Authorized OfficialWilliam M. PowersCeo · (908) 647-0800

Enumeration DateDecember 28, 2006

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1912063702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

3415 VALLEY ROAD, Liberty Corner, NJ 07938

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Other Names 1

Other NameBonnie Brae Residential Treatment Center

Other Identifiers 3

Medicaid0073661NJ

Medicaid0032506NJ

Medicaid8372403NJ

Other Providers at the Same Location NPPES 6

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

BONNIE BRAE

Psychiatric Residential Treatment Facility