Provider Demographics
NPI:1609235977
Name:WE CARE COMMUNITY WELLNESS CONNECTION
Entity Type:Organization
Organization Name:WE CARE COMMUNITY WELLNESS CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LIONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLADE
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-INTERN
Authorized Official - Phone:973-336-8139
Mailing Address - Street 1:296 KERRIGAN BLVD
Mailing Address - Street 2:SUITE 5 3RD FLOOR
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-3437
Mailing Address - Country:US
Mailing Address - Phone:973-336-8139
Mailing Address - Fax:973-373-1672
Practice Address - Street 1:296 KERRIGAN BLVD
Practice Address - Street 2:SUITE 5 3RD FLOOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3437
Practice Address - Country:US
Practice Address - Phone:973-336-8139
Practice Address - Fax:973-373-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00122100251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management