Tenerife LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

TENERIFE LLC

Practice address

3 Corbett Way
Eatontown, NJ 07724-2283

Phone

(657) 304-0103

NPI assigned

Mar 31, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gilbert Yates

Title

Contract Manager

Phone

(877) 262-7803

Specialties & licenses 4

Addresses

Other names 1

• Zinnia Life Care Doing business as

Tax ID family

Tenerife LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tenerife LLC

  • Substance Abuse Rehabilitation Facility
  • Denver, CO
  • NPI 1497598064
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1306586763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242283",
            "telephone_number": "657-304-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENERIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "877-262-7803"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zinnia Life Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Zinnia Life Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Tangel, MD
• David Tarrab, DDS
• Alexey Tatusov, M.D.
• Isaac Tawfik, MD
• Pamela Telisky, D.O.
• Denise Mary Tepper, M.S., P.T.
• Ysabel Teves
• The Arc of Monmouth, Inc.
• The Devereux Foundation
• The Eye Health Group, LLC

• All providers in Eatontown, NJ
• Developmental Disabilities Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.