Provider Demographics
NPI:1922162379
Name:IRON RECOVERY AND WELLNESS CENTER INC
Entity Type:Organization
Organization Name:IRON RECOVERY AND WELLNESS CENTER INC
Other - Org Name:SEASHORE FAMILY SERVICES OF NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE RECYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NEERJA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-8988
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:BLDG 6 STE A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-920-2700
Mailing Address - Fax:732-262-0707
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:BLDG 6 STE A
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723
Practice Address - Country:US
Practice Address - Phone:732-920-2700
Practice Address - Fax:732-262-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22269261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7602103Medicaid