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General NPI Number Information
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NPI Number | 1376161174
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Entity Type | Organization
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Legal Business Name | SMARTKID SUCCESS
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 176 US 9 NORTH SUITE 202 NORTHPOINT BUILDING
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726
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Country | US
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Telephone | 732-925-2195
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Fax |
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Provider Business Mailing Address
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Address Line | 176 US 9 NORTH SUITE 202 NORTHPOINT BUILDING
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726
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Country | US
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Telephone | 732-925-2195
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ASHOO JAIN
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Credential |
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Telephone | 732-925-2195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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