Provider Demographics
NPI:1518659127
Name:MPOWER WELLNESS NJ, LLC
Entity Type:Organization
Organization Name:MPOWER WELLNESS NJ, LLC
Other - Org Name:WELLNESS RECOVERY CENTER NEW JERSEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CMO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:PETRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-788-4460
Mailing Address - Street 1:231 CLARKSVILLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-5300
Mailing Address - Country:US
Mailing Address - Phone:888-292-4594
Mailing Address - Fax:
Practice Address - Street 1:231 CLARKSVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-5300
Practice Address - Country:US
Practice Address - Phone:888-292-4594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder