Provider Demographics
NPI:1245623263
Name:MANE STREAM, INC.
Entity type:Organization
Organization Name:MANE STREAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MS OT
Authorized Official - Phone:908-439-9636
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858-0305
Mailing Address - Country:US
Mailing Address - Phone:908-439-9636
Mailing Address - Fax:908-439-2338
Practice Address - Street 1:83 OLD TURNPIKE ROAD
Practice Address - Street 2:
Practice Address - City:OLDWICK
Practice Address - State:NJ
Practice Address - Zip Code:08858-0081
Practice Address - Country:US
Practice Address - Phone:908-439-9636
Practice Address - Fax:908-439-2338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation