Organization
YMCA OF GREATER MONMOUTH COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN WAGNER (VICE PRESIDENT)
(732) 290-9040
Entity
Organization
Contact information
Practice address
28 LILLIAN DR, HAZLET, NJ 07730-2631
(732) 290-9040
Mailing address
166 MAIN ST, MATAWAN, NJ 07747-3104
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0689572
—
NJ
Enumeration date
06/28/2019
Last updated
08/11/2020
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