Mini Mine LLC

NPI #1003557224 in Lakewood, New Jersey

Provider Information

NPI Number: 1003557224
Entity Type: Organization
Organization Name: Mini Mine LLC
Primary Specialty: Clinic/Center
Enumeration Date: Apr 3, 2022
Last Updated: Jun 17, 2024

Practice Location

Address: 128 MELVILLE AVE
City: Lakewood
State: New Jersey
ZIP Code: 08701-4235
Phone: (732) 886-8113

Authorized Official

Name: MRS. MALKA NUSSBAUM, BCBA
Title: CLINICAL DIRECTOR
Phone: (732) 886-8113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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