| 360 Soul Llc | |
|
1052 Broadway West Long Branch NJ 07764-1308 | |
| (732) 673-8956 | |
| Not Available |
| Full Name | 360 Soul Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1052 Broadway, West Long Branch, New Jersey |
| Authorized Official Name and Position | Ashley Lobbato (OWNER) |
| Authorized Official Contact | 7326738956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Soul Llc 1052 Broadway West Long Branch NJ 07764-1308 Ph: (732) 673-8956 | 360 Soul Llc 1052 Broadway West Long Branch NJ 07764-1308 Ph: (732) 673-8956 |
| NPI Number | 1144075953 |
|---|---|
| Provider Enumeration Date | 04/23/2024 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144075953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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