Provider Demographics
NPI:1477205235
Name:ROSE GOLD WELLNESS, LLC
Entity Type:Organization
Organization Name:ROSE GOLD WELLNESS, LLC
Other - Org Name:STRONG HOLISTIC HEALING, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:862-622-6289
Mailing Address - Street 1:39 S FULLERTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-6303
Mailing Address - Country:US
Mailing Address - Phone:862-622-6289
Mailing Address - Fax:
Practice Address - Street 1:39 S FULLERTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-6303
Practice Address - Country:US
Practice Address - Phone:862-622-6289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407235385OtherNPI
1598214819OtherNPI
1205278652OtherNPI