Provider Demographics
NPI:1093365041
Name:MARVELOUS ME THERAPY & SOCIAL SERVICES
Entity Type:Organization
Organization Name:MARVELOUS ME THERAPY & SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MSED/TSSH
Authorized Official - Phone:646-645-6929
Mailing Address - Street 1:1632 BOGART AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4004
Mailing Address - Country:US
Mailing Address - Phone:646-645-6929
Mailing Address - Fax:347-402-1055
Practice Address - Street 1:137 EVERGREEN PL
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2005
Practice Address - Country:US
Practice Address - Phone:646-645-6929
Practice Address - Fax:347-402-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251S00000XAgenciesCommunity/Behavioral Health