Provider Demographics
NPI:1174069702
Name:MOCEANS CENTER FOR INDEPENDENT LIVING INC.
Entity type:Organization
Organization Name:MOCEANS CENTER FOR INDEPENDENT LIVING INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-571-4884
Mailing Address - Street 1:279 BROADWAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6945
Mailing Address - Country:US
Mailing Address - Phone:732-505-2310
Mailing Address - Fax:
Practice Address - Street 1:1027 HOOPER AVE
Practice Address - Street 2:BLDG 6 FLR 3
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8363
Practice Address - Country:US
Practice Address - Phone:732-571-4884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOCEANS CENTER FOR INDEPENDENT LIVING INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management