Organization
TENERIFE LLC
Active
Organization
TENERIFE LLC
Active
Other names
Zinnia Life Care
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT YATES (CONTRACT MANAGER)
(877) 262-7803
Entity
Organization
Contact information
Practice address
3 CORBETT WAY, EATONTOWN, NJ 07724-2283
(657) 304-0103
Mailing address
3 CORBETT WAY, EATONTOWN, NJ 07724-2283
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/31/2022
Last updated
10/01/2024
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