Provider Demographics
NPI:1699560615
Name:ETALE AND MEANO
Entity type:Organization
Organization Name:ETALE AND MEANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONANGAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-652-4541
Mailing Address - Street 1:42 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1445
Mailing Address - Country:US
Mailing Address - Phone:973-652-4541
Mailing Address - Fax:973-228-7068
Practice Address - Street 1:2 CHERBOURG RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4008
Practice Address - Country:US
Practice Address - Phone:862-420-4311
Practice Address - Fax:973-228-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities