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Individual

SHMUEL GOTTLIEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
39 ASHFORD RD, JACKSON, NJ 08527-1701
(347) 786-1157
Mailing address
39 ASHFORD RD, JACKSON, NJ 08527-1701
(347) 786-1157

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
Primary
251X00000X
Supports Brokerage Agency

Other

Enumeration date
02/05/2025
Last updated
02/05/2025
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