| Papa Ganache Project, Llc | |
|
106 Main St Matawan NJ 07747-2656 | |
| (732) 217-1750 | |
| (732) 217-1749 |
| Full Name | Papa Ganache Project, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 106 Main St, Matawan, New Jersey |
| Authorized Official Name and Position | Lisa Dale Siroti (PRINCIPAL) |
| Authorized Official Contact | 7327700428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Papa Ganache Project, Llc 106 Main St Matawan NJ 07747-2656 Ph: (732) 217-1750 | Papa Ganache Project, Llc 106 Main St Matawan NJ 07747-2656 Ph: (732) 217-1750 |
| NPI Number | 1932523883 |
|---|---|
| Provider Enumeration Date | 02/13/2014 |
| Last Update Date | 02/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932523883 | NPI | - | NPPES |
| 0252069 | Medicaid | NJ |
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