MEDICARE: LAKEWOOD COMMUNITY SERVICES CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency	101920204	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093085649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEWOOD COMMUNITY SERVICES CORP.

Provider Business Mailing Address
First Line	:	450 W KENNEDY BLVD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1269
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 4TH ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3228
Country	:	US
Telephone Number	:	732-901-6001
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOSHE WEISBERG
Credential	:
Telephone Number	:	732-901-6001

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	12/30/2025

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