Provider Demographics
NPI:1356700082
Name:THE CENTER FOR FAMILY WELLNESS
Entity type:Organization
Organization Name:THE CENTER FOR FAMILY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA PD LMFT
Authorized Official - Phone:973-761-5140
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-0186
Mailing Address - Country:US
Mailing Address - Phone:973-761-5140
Mailing Address - Fax:
Practice Address - Street 1:11 GREY ROCK AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1218
Practice Address - Country:US
Practice Address - Phone:973-761-5140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health