Provider Demographics
NPI:1164774998
Name:JSAS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:JSAS HEALTHCARE, INC.
Other - Org Name:JERSEY SHORE ADDICTION SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-988-8877
Mailing Address - Street 1:685 NEPTUNE BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4118
Mailing Address - Country:US
Mailing Address - Phone:732-988-8877
Mailing Address - Fax:732-988-2572
Practice Address - Street 1:685 NEPTUNE BLVD
Practice Address - Street 2:STE 101
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4118
Practice Address - Country:US
Practice Address - Phone:732-988-8877
Practice Address - Fax:732-988-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000316261QM2800X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7632801Medicaid