MEDICARE: MOCEANS CENTER FOR INDEPENDENT LIVING, INC

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

General Provider Information

NPI Number	:	1215164694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOCEANS CENTER FOR INDEPENDENT LIVING, INC

Provider Business Mailing Address
First Line	:	213 BROADWAY
Second Line	:	ROOM 102
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740
Country	:	US
Telephone Number	:	732-571-4884
Fax Number	:	866-856-0290

Provider Business Practice Location Address
First Line	:	213 BROADWAY RM 102
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-7005
Country	:	US
Telephone Number	:	732-571-4884
Fax Number	:	866-856-0290

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. JUDYTH BROWN
Credential	:	MS ED
Telephone Number	:	732-566-7585

Provider Enumeration Date	:	06/12/2009
Last Update Date	:	08/01/2023

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