Provider Demographics
NPI:1073918504
Name:ANEW WELLNESS, LLC
Entity Type:Organization
Organization Name:ANEW WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:K
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:732-328-2639
Mailing Address - Street 1:270 DAVIDSON AVENUE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4140
Mailing Address - Country:US
Mailing Address - Phone:732-328-2639
Mailing Address - Fax:800-878-9212
Practice Address - Street 1:270 DAVIDSON AVENUE
Practice Address - Street 2:SUITE 105
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4140
Practice Address - Country:US
Practice Address - Phone:732-328-2639
Practice Address - Fax:800-878-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health