Provider Demographics
NPI:1508611864
Name:WELLNESS - HOPE & YOU
Entity Type:Organization
Organization Name:WELLNESS - HOPE & YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, LPC, LCADC
Authorized Official - Phone:973-851-7830
Mailing Address - Street 1:159 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-2208
Mailing Address - Country:US
Mailing Address - Phone:973-851-7830
Mailing Address - Fax:
Practice Address - Street 1:159 3RD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2208
Practice Address - Country:US
Practice Address - Phone:973-851-7830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)