Provider Demographics
NPI:1700489580
Name:RAMBLER MENTAL HEALTH
Entity Type:Organization
Organization Name:RAMBLER MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GILRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-501-8820
Mailing Address - Street 1:1001 FISCHER BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3818
Mailing Address - Country:US
Mailing Address - Phone:732-501-8820
Mailing Address - Fax:
Practice Address - Street 1:106 BROWN AVE
Practice Address - Street 2:
Practice Address - City:LAVALLETTE
Practice Address - State:NJ
Practice Address - Zip Code:08735-2208
Practice Address - Country:US
Practice Address - Phone:732-501-8820
Practice Address - Fax:772-647-7552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty