Organization
LA GOMERA LLC
Active
Other names
Zinnia Children and Family
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE BUCHEGER (BILLING DIRECTOR)
(262) 490-7933
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
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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