Provider Demographics
NPI:1942542741
Name:ATLANTIC PREVENTION RESOURCES
Entity Type:Organization
Organization Name:ATLANTIC PREVENTION RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZLOTNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-272-0101
Mailing Address - Street 1:1416 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-1037
Mailing Address - Country:US
Mailing Address - Phone:609-272-0101
Mailing Address - Fax:609-241-8960
Practice Address - Street 1:1416 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232
Practice Address - Country:US
Practice Address - Phone:609-272-0101
Practice Address - Fax:609-241-8960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20001048261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0203416Medicaid