Provider Demographics
NPI:1457146763
Name:CONNECT WELLNESS CENTER LLC
Entity type:Organization
Organization Name:CONNECT WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAUFIKA
Authorized Official - Middle Name:HAFIZ
Authorized Official - Last Name:SAKHAWAT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW
Authorized Official - Phone:732-322-7609
Mailing Address - Street 1:303 PRESERVE LN
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1794
Mailing Address - Country:US
Mailing Address - Phone:732-322-7609
Mailing Address - Fax:
Practice Address - Street 1:9821 OLDE 8 RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1468
Practice Address - Country:US
Practice Address - Phone:732-322-7609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty