Provider Demographics
NPI:1245895424
Name:THE WELL OF TRUTH, INC.
Entity type:Organization
Organization Name:THE WELL OF TRUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-887-4614
Mailing Address - Street 1:105 N CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-2151
Mailing Address - Country:US
Mailing Address - Phone:516-887-4614
Mailing Address - Fax:516-887-4686
Practice Address - Street 1:105 N CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-2151
Practice Address - Country:US
Practice Address - Phone:516-887-4614
Practice Address - Fax:516-887-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty