Provider Demographics
NPI:1205557675
Name:COLLEGE ACHIEVE GREATER ASBURY PARK
Entity type:Organization
Organization Name:COLLEGE ACHIEVE GREATER ASBURY PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SCHOOL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLANDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-902-7274
Mailing Address - Street 1:3455 WEST BANGS AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-774-0727
Mailing Address - Fax:
Practice Address - Street 1:3455 WEST BANGS AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-774-0727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty