Provider Demographics
NPI:1700100039
Name:ADVERT COMMUNITY HEALTH PROJECT LLC
Entity Type:Organization
Organization Name:ADVERT COMMUNITY HEALTH PROJECT LLC
Other - Org Name:CARE NETWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:G.M
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:AVERY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:609-423-4150
Mailing Address - Street 1:143 E STATE ST
Mailing Address - Street 2:SUITE 813
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08608-1714
Mailing Address - Country:US
Mailing Address - Phone:609-423-4150
Mailing Address - Fax:
Practice Address - Street 1:143 E STATE ST
Practice Address - Street 2:SUITE 813
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1714
Practice Address - Country:US
Practice Address - Phone:609-423-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ302R00000X
305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0282812Medicaid
NJ02501Medicare PIN