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Organization

PAPA GANACHE, LLP

Active
Other names
PG - Strengths Development Program
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA DALE SIROTI LCSW (PRINCIPAL)
(732) 770-0428
Entity
Organization

Contact information

Practice address
25 CHURCH ST, KEYPORT, NJ 07735-1508
(732) 217-1750
(732) 217-1749
Mailing address
25 CHURCH ST, KEYPORT, NJ 07735-1508
(732) 217-1750
(732) 217-1749

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05262800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0224031
NJ
Enumeration date
05/18/2010
Last updated
12/28/2010
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