Provider Demographics
NPI:1952950503
Name:CHANGING SEASONS WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:CHANGING SEASONS WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-623-6326
Mailing Address - Street 1:17 SORRENTO RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4857
Mailing Address - Country:US
Mailing Address - Phone:203-623-6326
Mailing Address - Fax:
Practice Address - Street 1:605 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1123
Practice Address - Country:US
Practice Address - Phone:203-623-6326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty