Provider Demographics
NPI:1568853646
Name:24 DUGANS GROVE LLC
Entity Type:Organization
Organization Name:24 DUGANS GROVE LLC
Other - Org Name:MONROE MEDICAL ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALOK
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CALA
Authorized Official - Phone:732-851-6720
Mailing Address - Street 1:24 DUGANS GROVE ROAD
Mailing Address - Street 2:518 RT 33
Mailing Address - City:MILLSTONE
Mailing Address - State:NJ
Mailing Address - Zip Code:08535
Mailing Address - Country:US
Mailing Address - Phone:732-851-6720
Mailing Address - Fax:
Practice Address - Street 1:24 DUGANS GROVE ROAD
Practice Address - Street 2:518 RT 33
Practice Address - City:MILLSTONE
Practice Address - State:NJ
Practice Address - Zip Code:08535
Practice Address - Country:US
Practice Address - Phone:732-851-6720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care