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General NPI Number Information
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NPI Number | 1467154708
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Entity Type | Organization
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Legal Business Name | MERKABA MTS, LLC.
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 711 STUYVESANT AVE # A
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City | IRVINGTON
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State | NJ
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Zip | 07111-1823
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Country | US
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Telephone | 732-217-4717
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1294
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City | UNION
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State | NJ
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Zip | 07083-1294
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Country | US
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Telephone | 732-217-4717
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. SHELLEY TAYLOR
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Credential | LSW
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Telephone | 732-217-4717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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