Provider Demographics
NPI:1659732410
Name:ATSI WELLNESS GROUP
Entity Type:Organization
Organization Name:ATSI WELLNESS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-720-5296
Mailing Address - Street 1:4 EAST JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE #10
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205
Mailing Address - Country:US
Mailing Address - Phone:609-752-3576
Mailing Address - Fax:609-241-6573
Practice Address - Street 1:4 EAST JIMMIE LEEDS RD
Practice Address - Street 2:SUITE #10
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205
Practice Address - Country:US
Practice Address - Phone:609-752-3576
Practice Address - Fax:609-241-6573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06872200261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder