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General NPI Number Information
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NPI Number | 1629558739
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Entity Type | Organization
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Legal Business Name | GREEN MEADOWS THERAPY CENTER AND SERVICES
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 251 OAK GLEN RD
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City | HOWELL
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State | NJ
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Zip | 07731-8616
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Country | US
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Telephone | 732-272-0177
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Fax | 732-358-0162
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Provider Business Mailing Address
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Address Line | 251 OAK GLEN RD
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City | HOWELL
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State | NJ
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Zip | 07731-8616
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Country | US
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Telephone | 732-272-0177
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Fax | 732-358-0162
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Authorized Official
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Title or Position | MANAGER
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Name | ARYEH PETEGORSKY
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Credential |
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Telephone | 732-503-6119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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