MEDICARE: COOPERATIVE CARE PARTNERSHIP, 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	2000559	NJ
2	251S00000X	Community/Behavioral Health Agency	37PC00448800	NJ

General Provider Information

NPI Number	:	1477898096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOPERATIVE CARE PARTNERSHIP, INC

Provider Business Mailing Address
First Line	:	1076 ROUTE 47 S
Second Line	:
City	:	RIO GRANDE
State	:	NJ
Zip	:	08242-1608
Country	:	US
Telephone Number	:	609-741-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1076 ROUTE 47 S
Second Line	:
City	:	RIO GRANDE
State	:	NJ
Zip	:	08242-1608
Country	:	US
Telephone Number	:	609-741-6363
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH THERAPIST/PARTNER
Name	:	SHANNA LEARN
Credential	:	LPC
Telephone Number	:	814-504-3514

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	01/07/2026

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