Provider Demographics
NPI:1659085645
Name:JOHN BROOKS RECOVERY CENTER
Entity Type:Organization
Organization Name:JOHN BROOKS RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:D
Authorized Official - Last Name:SNELLBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-457-0467
Mailing Address - Street 1:1455 PINEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2068
Mailing Address - Country:US
Mailing Address - Phone:609-345-2020
Mailing Address - Fax:
Practice Address - Street 1:1455 PINEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2068
Practice Address - Country:US
Practice Address - Phone:609-345-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTICARE HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-13
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0881058Medicaid