Healthcare Provider Details

I. General information

NPI: 1659877058
Provider Name (Legal Business Name): MATAWAN ADULT DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3996 COUNTY RD 516 STE 101
MATAWAN NJ
07747-7017
US

IV. Provider business mailing address

3996 COUNTY RD 516 STE 101
MATAWAN NJ
07747-7017
US

V. Phone/Fax

Practice location:
  • Phone: 732-391-8100
  • Fax:
Mailing address:
  • Phone: 732-391-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ZENGERLE
Title or Position: EXECUTIVE DIRECTOR
Credential: LNHA
Phone: 732-391-8100