Organization
YMCA OF THE JERSEY SHORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T KELLY (CFO)
(732) 290-9040
Entity
Organization
Contact information
Practice address
166 MAIN ST, MATAWAN, NJ 07747-3104
(732) 290-9040
(732) 566-0433
Mailing address
166 MAIN ST, MATAWAN, NJ 07747-3104
(732) 290-9040
(732) 566-0433
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100050104
NJ
251S00000X
Community/Behavioral Health Agency
2000341
NJ
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035807
—
NJ
05
—
0464872
—
NJ
05
—
8815054
—
NJ
Enumeration date
12/29/2006
Last updated
08/28/2025
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