La Gomera LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

LA GOMERA LLC

Doing business as

Zinnia Children and Family

Practice address

3 Corbett Way
Eatontown, NJ 07724-2283

Phone

(657) 304-0103

NPI assigned

Mar 31, 2022

Last updated

Mar 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Catherine Bucheger

Title

Billing Director

Phone

(262) 490-7933

Specialties & licenses 4

Addresses

Other names 1

• Zinnia Children and Family Doing business as

Locations

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1497495840",
    "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": "LA GOMERA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BUCHEGER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "262-490-7933"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zinnia Children and Family",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald W Kristan, MD
• Andrea Kristensen
• Marjorie Ann Kulesza, LCSW
• Sherry Kumar, MD
• Christopher Patrick Kutney, DMD
• Nelson Lamarche, M.D.
• Frank Lambrinos
• Elizabeth Landy, DPT
• Christopher Lastella
• Kayla Lax

• Emotionally Disturbed Childrens' Residential Treatment Facility in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.