Provider Demographics
NPI:1598319378
Name:ENLIGHTENMENT ENTREPRENEURIAL ENTERPRISES INC.
Entity Type:Organization
Organization Name:ENLIGHTENMENT ENTREPRENEURIAL ENTERPRISES INC.
Other - Org Name:GYMGUYZ OF BERGEN COUNTY, GOLD COAST, NORTH HUDSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-292-1802
Mailing Address - Street 1:7000 KENNEDY BLVD E APT 47D
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4862
Mailing Address - Country:US
Mailing Address - Phone:201-881-8281
Mailing Address - Fax:
Practice Address - Street 1:7000 KENNEDY BLVD E UNIT 47D
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-4862
Practice Address - Country:US
Practice Address - Phone:201-881-8281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty
No226000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreational Therapist AssistantGroup - Multi-Specialty
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapistGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate HealthGroup - Multi-Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty