| Create Change Wellness Center Llc | |
|
50 E 37th St Paterson NJ 07514-1212 | |
| (973) 567-5941 | |
| Not Available |
| Full Name | Create Change Wellness Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 50 E 37th St, Paterson, New Jersey |
| Authorized Official Name and Position | Cyrena M Dussard (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9735675941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Create Change Wellness Center Llc 50 E 37th St Paterson NJ 07514-1212 Ph: (973) 567-5941 | Create Change Wellness Center Llc 50 E 37th St Paterson NJ 07514-1212 Ph: (973) 567-5941 |
| NPI Number | 1619533916 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 05/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619533916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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