FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Atlantic County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000275 John Brooks Recovery Center 660 Black Horse Pike Pleasantville, NJ 08232 Email: [email protected] Phone: (609) 345-2020 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000637 John Brooks Recovery Center - OTP Bacharach Blvd. 1931 BACHARACH BLVD. ATLANTIC CITY, NJ 08401 Email: [email protected] Phone: (609) 345-2020 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Bergen County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000321 Team Management 2000, Inc. 84 Main Street Hackensack, NJ 07601 Email: [email protected] Phone: (201) 487-4700 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Camden County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000084 Delaware Valley Medical 7980 S CRESCENT BLVD (RT. 130 PENNSAUKEN, NJ 08109 Email: [email protected] Phone: (856) 665-5100 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000218 Hispanic Family Center of Southern New Jersey 2700 WESTFIELD AVE CAMDEN, NJ 08105 Email: [email protected] Phone: (856) 365-7393 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000198 SODAT of NJ, Inc. Camden Office 805-815 FEDERAL STREET CAMDEN, NJ 08101 Email: [email protected] Phone: (856) 964-5000 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Camden County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes SITE LICENSE # 2000491 STAND4RECOVERY PROGRAM 316 HADDON AVE COLLINGSWOOD, NJ 08108 Email: [email protected] Phone: (856) 240-1417 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes SITE LICENSE # 2000463 Unity Place Program, LLC 1 Keystone Avenue Cherry Hill, NJ 08003 Email: [email protected] Phone: (856) 424-4142 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000459 Urban Treatment Associates, Inc. 808 Market Street Camden, NJ 08102 Email: [email protected] Phone: (856) 338-1811 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Camden County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000465 Urban Treatment Associates, Inc. 808 MARKET ST, BASEMENT LEVEL CAMDEN, NJ 08101 Email: [email protected] Phone: (856) 225-0505 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Essex County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000136 East Orange Substance Abuse Treatment Program 110 S. Grove Street East Orange, NJ 07018-2693 Email: [email protected] Phone: (973) 266-5200 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000025 Family Service Bureau of Newark 274 South Orange Ave Newark, NJ 07103 Email: [email protected] Phone: (973) 286-2821 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000050 Integrity House Academy 1091-1093 BROAD ST NEWARK, NJ 07114 Email: [email protected] Phone: (973) 623-0600 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Essex County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000333 Integrity, Inc. 26-28 LONGWORTH ST NEWARK, NJ 07102 Email: [email protected] Phone: (973) 623-0600 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000546 New Directions Behavioral Health Center 9 LINCOLN PARK NEWARK, NJ 07102 Email: [email protected] Phone: (973) 242-6599 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000054 Team Management 2000, Inc. CBO 972 BROAD STREET NEWARK, NJ 07102 Email: [email protected] Phone: (973) 273-0425 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Essex County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes SITE LICENSE # 2000689 The Appropriate Place, Inc. 660 S. 21ST STREET IRVINGTON, NJ 07111 Email: [email protected] Phone: (862) 253-1104 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000196 The Lennard Clinic, Inc. 461 Frelinghuysen Avenue Newark, NJ 07114 Email: [email protected] Phone: (973) 596-2850 VIVITROL STATUS: Not Interested OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes Yes SITE LICENSE # 2000249 The Wise Program 659 MARTIN LUTHER KING BLVD NEWARK, NJ 07102-1119 Email: [email protected] Phone: (973) 623-0600 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes Yes APPROVED Levels of Care for MATI Amb Yes Yes FFS Network Providers Approved for Ambulatory Medication Assisted Treatment Initiative as of 10/15/2019 Essex County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes SITE LICENSE # 2000288 Turning Point, Inc. 15 BLOOMFIELD AVE VERONA, NJ 07044 Email: [email protected] Phone: (973) 239-9400 VIVITROL STATUS: Approved OP IOP PC AWM MOP STR LTR HH IWM LICENSED Levels of Care Yes Yes APPROVED Levels of Care for MATI Amb Yes Gloucester County Clinical Review COOC Medically Assisted Treatment Recovery Support Medical Services Interim Services Yes Yes Yes Yes Yes SITE LICENSE # 2000403 The Wounded Healer Inc., dba My friends House Family Counseling Services 371 Glassboro Road Woodbury Heights, NJ 08097 Email: [email protected] Phone: (856) 669-6900 VIVITROL STATUS: Not Interested