Organization
SHINING LIGHTS OF NJ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TZIVIA LESSER (FIRST BOARD OF TRUSTEES)
(732) 364-8011
Entity
Organization
Contact information
Practice address
500 SUMMER AVE, LAKEWOOD, NJ 08701-4616
(732) 364-8011
Mailing address
PO BOX 1314, LAKEWOOD, NJ 08701-1010
(732) 364-8011
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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