Provider Demographics
NPI:1013141639
Name:JOURNEY TO WELLNESS, INC.
Entity Type:Organization
Organization Name:JOURNEY TO WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMISSARENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-391-8547
Mailing Address - Street 1:69 PENNSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5282
Mailing Address - Country:US
Mailing Address - Phone:848-391-8547
Mailing Address - Fax:
Practice Address - Street 1:222 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4126
Practice Address - Country:US
Practice Address - Phone:848-391-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty