Provider Demographics
NPI:1952433724
Name:TOWNCO CONSULTANTS, INC
Entity Type:Organization
Organization Name:TOWNCO CONSULTANTS, INC
Other - Org Name:YOUNG AT HEART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-775-4462
Mailing Address - Street 1:600 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6518
Mailing Address - Country:US
Mailing Address - Phone:732-775-4462
Mailing Address - Fax:
Practice Address - Street 1:115 GRAWTOWN RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5106
Practice Address - Country:US
Practice Address - Phone:732-928-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ080195261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5592208Medicaid