Provider Demographics
NPI:1407950140
Name:JERSEY SHORE UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:JERSEY SHORE UNIVERSITY MEDICAL CENTER
Other - Org Name:MERIDIAN BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:ASST NS MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:METTA
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:732-776-4081
Mailing Address - Street 1:8 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2507
Mailing Address - Country:US
Mailing Address - Phone:732-776-4081
Mailing Address - Fax:
Practice Address - Street 1:1945 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-776-4081
Practice Address - Fax:732-776-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO05915400282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital