Organization
ACTIVE DAY ADULT SOCIAL SERVICES
Active
Other names
Active Day Adult Services
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA LARINA (MANAGER)
(732) 851-6640
Entity
Organization
Contact information
Practice address
20 JACKSON ST STE 1A, FREEHOLD, NJ 07728-2476
(732) 845-3332
(732) 845-3339
Mailing address
20 JACKSON ST STE 1A, FREEHOLD, NJ 07728-2476
(732) 845-3332
(732) 845-3339
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NJ
261QA0600X
Adult Day Care Clinic/Center
Primary
13008
NJ
Other
Enumeration date
05/25/2015
Last updated
01/14/2016
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