Provider Demographics
NPI:1407582877
Name:GARDEN STATE WELLNESS AND CARE MANAGEMENT
Entity Type:Organization
Organization Name:GARDEN STATE WELLNESS AND CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-221-6400
Mailing Address - Street 1:4 SWIMMING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1727
Mailing Address - Country:US
Mailing Address - Phone:732-428-6636
Mailing Address - Fax:
Practice Address - Street 1:4 SWIMMING RIVER RD
Practice Address - Street 2:
Practice Address - City:LINCROFT
Practice Address - State:NJ
Practice Address - Zip Code:07738-1727
Practice Address - Country:US
Practice Address - Phone:732-428-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty