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General NPI Number Information
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NPI Number | 1417596768
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Entity Type | Organization
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Legal Business Name | ROCK OUT LOUD
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Dates
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Enumeration Date | 01/04/2020
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Last Update Date | 01/04/2020
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Provider Practice Location Address
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Address Line | 12 US HIGHWAY 9 UNIT 102
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1575
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Country | US
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Telephone | 732-984-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 12 US HIGHWAY 9 UNIT 102
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1575
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Country | US
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Telephone | 732-984-4060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL GRANDE
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Credential |
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Telephone | 917-270-1524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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