Organization · Type 2 NPI
La Gomera LLC
Emotionally Disturbed Childrens' Residential Treatment Facility · Eatontown, NJ
NPI number
1497495840
Active
Practice location
3 Corbett Way
Eatontown, NJ 07724-2283
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | None listed |
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | None listed |
| Psychiatric Residential Treatment Facility | 323P00000X | None listed |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
9 other providers at this address
- Advanced Health & EducationCommunity/Behavioral Health Agency Eatontown, NJ NPI 1073889358
- Monmouth Behavioral Diagnostics, LLCClinical Medical Laboratory Eatontown, NJ NPI 1578989935
- Tenerife LLCDevelopmental Disabilities Clinic/Center Eatontown, NJ NPI 1306586763
- Zinnia Aba LLCAdult Day Care Clinic/Center Eatontown, NJ NPI 1164189965
- Agnes ShanleyMassage Therapist Eatontown, NJ NPI 1881077824
- Barbara A. RexerClinical Social Worker Eatontown, NJ NPI 1295209898
- Candace Kotkin-Decarvalho, LCADCAddiction (Substance Use Disorder) Counselor Eatontown, NJ NPI 1740896042
- Isabella Laura Montalvo, LPC, LAATMental Health Counselor Eatontown, NJ NPI 1467274316
- Jo Myman, LCADCAddiction (Substance Use Disorder) Counselor Eatontown, NJ NPI 1629631627
About NPI 1497495840
La Gomera LLC's National Provider Identifier is 1497495840, issued on Mar 31, 2022. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Eatontown, NJ. The record was last updated on Mar 31, 2022.