Provider Demographics
NPI:1639332885
Name:WHOLE CHILD CENTER, LLC
Entity Type:Organization
Organization Name:WHOLE CHILD CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-634-1600
Mailing Address - Street 1:690 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1524
Mailing Address - Country:US
Mailing Address - Phone:201-634-1600
Mailing Address - Fax:201-634-1606
Practice Address - Street 1:690 KINDERKAMACK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1524
Practice Address - Country:US
Practice Address - Phone:201-634-1600
Practice Address - Fax:201-634-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty