Provider Demographics
NPI:1689235046
Name:SSNY CARES LLC
Entity Type:Organization
Organization Name:SSNY CARES LLC
Other - Org Name:SSNY CARES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-261-6802
Mailing Address - Street 1:186 ROUTE 537
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1678
Mailing Address - Country:US
Mailing Address - Phone:732-261-6802
Mailing Address - Fax:
Practice Address - Street 1:186 ROUTE 537
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1678
Practice Address - Country:US
Practice Address - Phone:732-261-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No252Y00000XAgenciesEarly Intervention Provider Agency
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0736236Medicaid