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General NPI Number Information
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NPI Number | 1194436360
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Entity Type | Organization
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Legal Business Name | LAKEWOOD RESOURCE AND REFERRAL CENTER INC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 1171 RIVER AVENUE
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-364-2144
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Fax | 732-364-3559
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Provider Business Mailing Address
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Address Line | 1771 MADISON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-364-2144
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Fax | 732-534-8540
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Authorized Official
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Title or Position | C.E.O.
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Name | DAVID FRIEDMAN
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Credential |
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Telephone | 732-364-2144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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