=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437549169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEARCH DAY PROGRAM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2015
-----------------------------------------------------
Last Update Date | 02/03/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 144 ROBERTSVILLE ROAD
-----------------------------------------------------
City | FREEHOLD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-462-7972
-----------------------------------------------------
Fax | 732-845-4938
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 73 WICKAPECKO DRIVE
-----------------------------------------------------
City | OCEAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-531-0454
-----------------------------------------------------
Fax | 732-531-5934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. KATHERINE SOLANA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-531-0454
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 313M00000X
-----------------------------------------------------
Taxonomy Name | Nursing Facility/Intermediate Care Facility
-----------------------------------------------------
License Number | GH052
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------