| Ymca Of Greater Monmouth County | |
|
1025 Larsen Rd Jackson NJ 08527-1315 | |
| (732) 290-9040 | |
| (732) 566-0433 |
| Full Name | Ymca Of Greater Monmouth County |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1025 Larsen Rd, Jackson, New Jersey |
| Authorized Official Name and Position | Leeann Wagner (VICE PRESIDENT) |
| Authorized Official Contact | 7322909040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ymca Of Greater Monmouth County 166 Main St Matawan NJ 07747-3104 Ph: (732) 290-9040 | Ymca Of Greater Monmouth County 1025 Larsen Rd Jackson NJ 08527-1315 Ph: (732) 290-9040 |
| NPI Number | 1184103061 |
|---|---|
| Provider Enumeration Date | 08/10/2018 |
| Last Update Date | 08/11/2020 |
| Certification Date | 08/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184103061 | NPI | - | NPPES |
| 0663522 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1000054804 (New Jersey) | Primary |
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