Provider Demographics
NPI:1275867467
Name:IRON RECOVERY AND WELLNESS CENTER INC
Entity Type:Organization
Organization Name:IRON RECOVERY AND WELLNESS CENTER INC
Other - Org Name:SEASHORE FAMILY SERVICES OF NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE RECYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NEERJA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-8988
Mailing Address - Street 1:226 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7469
Mailing Address - Country:US
Mailing Address - Phone:732-244-1600
Mailing Address - Fax:732-349-5532
Practice Address - Street 1:226 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7469
Practice Address - Country:US
Practice Address - Phone:732-244-1600
Practice Address - Fax:732-349-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000351261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119466Medicaid