Provider Demographics
NPI:1619573995
Name:THE FAMILY HEALTH AND WELLNESS OPPORTUNITY CENTER
Entity Type:Organization
Organization Name:THE FAMILY HEALTH AND WELLNESS OPPORTUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:OHLIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-635-4268
Mailing Address - Street 1:200B W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-2526
Mailing Address - Country:US
Mailing Address - Phone:856-422-9300
Mailing Address - Fax:856-422-9299
Practice Address - Street 1:200B W HIGH ST
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2526
Practice Address - Country:US
Practice Address - Phone:856-422-9300
Practice Address - Fax:856-422-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)