=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750232831
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YMCA OF THE JERSEY SHORE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2026
-----------------------------------------------------
Last Update Date | 02/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 613 HOPE RD
-----------------------------------------------------
City | EATONTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07724-1278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-290-9040
-----------------------------------------------------
Fax | 732-544-4644
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 613 HOPE RD
-----------------------------------------------------
City | EATONTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07724-1278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-290-9040
-----------------------------------------------------
Fax | 732-544-4644
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | CORY CUOMO
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 732-290-9040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------