Provider Demographics
NPI:1568760932
Name:THE LEARNING WELL FOR CHILDREN LLC
Entity Type:Organization
Organization Name:THE LEARNING WELL FOR CHILDREN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:ESTRELLA
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SPL, LDT/C
Authorized Official - Phone:609-315-5992
Mailing Address - Street 1:15 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08518-1318
Mailing Address - Country:US
Mailing Address - Phone:609-315-5992
Mailing Address - Fax:609-360-3038
Practice Address - Street 1:15 W FRONT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-1318
Practice Address - Country:US
Practice Address - Phone:609-315-5992
Practice Address - Fax:609-360-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00161700251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health