| Our Special Place, Inc. | |
|
62 Broad St Matawan NJ 07747-2534 | |
| (732) 765-8500 | |
| Not Available |
| Full Name | Our Special Place, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 62 Broad St, Matawan, New Jersey |
| Authorized Official Name and Position | Dawn Fittipaldi (EDUCATIONAL DIRECTOR/VICE PRESIDENT) |
| Authorized Official Contact | 7327658500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Special Place, Inc. 62 Broad St Matawan NJ 07747-2534 Ph: (732) 765-8500 | Our Special Place, Inc. 62 Broad St Matawan NJ 07747-2534 Ph: (732) 765-8500 |
| NPI Number | 1154788057 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 01/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154788057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0100983768 (New Jersey) | Primary |
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