Provider Demographics
NPI:1831725068
Name:ETERNAL WELLNESS
Entity type:Organization
Organization Name:ETERNAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINARLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAP
Authorized Official - Phone:516-702-8098
Mailing Address - Street 1:5288 GRANDE PALM CIR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1362
Mailing Address - Country:US
Mailing Address - Phone:516-702-8098
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5195
Practice Address - Country:US
Practice Address - Phone:516-702-8098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty