Healthcare Provider Details

I. General information

NPI: 1588505366
Provider Name (Legal Business Name): MARVELOUS MIND CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 PALISADE AVE
GARFIELD NJ
07026-2901
US

IV. Provider business mailing address

300 AVALON DR UNIT 3184
WOOD RIDGE NJ
07075-1015
US

V. Phone/Fax

Practice location:
  • Phone: 917-391-6837
  • Fax:
Mailing address:
  • Phone: 917-391-6837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: LEXIS GREENE
Title or Position: DIRECTOR
Credential:
Phone: 917-391-6837