Provider Demographics
NPI:1184493561
Name:TOMS RIVER FIELD OF DREAMS
Entity type:Organization
Organization Name:TOMS RIVER FIELD OF DREAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-998-3667
Mailing Address - Street 1:37 HARPERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2926
Mailing Address - Country:US
Mailing Address - Phone:732-998-3667
Mailing Address - Fax:
Practice Address - Street 1:1505 N BAY AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3301
Practice Address - Country:US
Practice Address - Phone:732-998-3667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health