Provider Demographics
NPI:1205644333
Name:LAKEWOOD RESOURCE AND REFERRAL CENTER, INC.
Entity type:Organization
Organization Name:LAKEWOOD RESOURCE AND REFERRAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-2144
Mailing Address - Street 1:1771 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1242
Mailing Address - Country:US
Mailing Address - Phone:732-364-6666
Mailing Address - Fax:732-364-3559
Practice Address - Street 1:1771 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1242
Practice Address - Country:US
Practice Address - Phone:732-364-6666
Practice Address - Fax:732-364-3559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKEWOOD RESOURCE AND REFERRAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)