Provider Demographics
NPI:1104791847
Name:DRW HEALTHCARE SERVICES & MENTAL HEALTH WELLNESS, LLC
Entity type:Organization
Organization Name:DRW HEALTHCARE SERVICES & MENTAL HEALTH WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:WARREN-SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:973-508-3161
Mailing Address - Street 1:290 SPRINGFIELD AVE UNIT 8001
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-7000
Mailing Address - Country:US
Mailing Address - Phone:973-508-3161
Mailing Address - Fax:973-242-9339
Practice Address - Street 1:290 SPRINGFIELD AVE UNIT 8001
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-7000
Practice Address - Country:US
Practice Address - Phone:973-508-3161
Practice Address - Fax:973-242-9339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRW HEALTHCARE SERVICES & MENTAL HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Multi-Specialty