YMCA of Greater Monmouth County
Organization Active NPI Community/Behavioral Health Agency · Port Monmouth, NJ
NPI 1982142220 · NPPES record last updated Aug 11, 2020
Key facts
- NPI
- 1982142220
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 100052505 (NJ)
- Legal business name
- YMCA OF GREATER MONMOUTH COUNTY
- Practice address
- 202 Main St
Port Monmouth, NJ 07758-1252 - Phone
- (732) 290-9040
- Fax
- (732) 566-0433
- NPI assigned
- Feb 7, 2017
- Organization subpart
- No
Authorized official
- Name
- Leeann Wagner
- Title
- Vice President
- Phone
- (732) 290-9040
Corporate family (same tax ID) 15
National Provider Directory
- Tax ID family
- YMCA of the Jersey Shore
Locations
202 Main St
Port Monmouth, NJ 07758
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 100052505 | NJ | Yes |
Addresses
Primary practice location
202 Main St
Port Monmouth, NJ 07758-1252
Mailing address
166 Main St
Matawan, NJ 07747-3104
Phone (732) 290-9040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0411299 | Medicaid | NJ |
Other providers in Port Monmouth, NJ
All providers in Port Monmouth, NJ · Community/Behavioral Health Agency in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.