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General NPI Number Information
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NPI Number | 1700489580
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Entity Type | Organization
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Legal Business Name | RAMBLER MENTAL HEALTH
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 106 BROWN AVE
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City | LAVALLETTE
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State | NJ
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Zip | 08735-2208
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Country | US
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Telephone | 732-501-8820
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Fax | 772-647-7552
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Provider Business Mailing Address
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Address Line | 1001 FISCHER BLVD STE 3
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3818
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Country | US
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Telephone | 732-501-8820
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KYLE J. GILRAIN
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Credential | LCSW
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Telephone | 732-501-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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