Provider Demographics
NPI:1356805881
Name:AMAZING STRIDES OF NJ LLC
Entity type:Organization
Organization Name:AMAZING STRIDES OF NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-351-5001
Mailing Address - Street 1:#322, 270 SPARTA AVE.
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:570-351-5001
Mailing Address - Fax:570-241-0397
Practice Address - Street 1:#322, 270 SPARTA AVE.
Practice Address - Street 2:SUITE 104
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:570-351-5001
Practice Address - Fax:570-241-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty