| Jersey Innovative Services Llc | |
|
2360 Lakewood Rd Suite 3 #256 Toms River NJ 08755-1929 | |
| (732) 614-6145 | |
| (732) 612-1162 |
| Full Name | Jersey Innovative Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2360 Lakewood Rd, Toms River, New Jersey |
| Authorized Official Name and Position | Erika Hollander (MANAGER) |
| Authorized Official Contact | 7326146145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jersey Innovative Services Llc 2360 Lakewood Rd Suite 3 #256 Toms River NJ 08755-1929 Ph: (732) 614-6145 | Jersey Innovative Services Llc 2360 Lakewood Rd Suite 3 #256 Toms River NJ 08755-1929 Ph: (732) 614-6145 |
| NPI Number | 1043757990 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 02/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043757990 | NPI | - | NPPES |
| 0169994 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | XXX (New Jersey) | Primary |
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