| Inner Wellth LLC | |
|
420 Boulevard Suite 101 Mountain Lakes NJ 07046-1742 | |
| (973) 321-4380 | |
| (973) 794-5350 |
| Full Name | Inner Wellth LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 420 Boulevard, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Randolph Scott Shipon (MEMBER) |
| Authorized Official Contact | 9733214380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Wellth LLC 420 Boulevard Suite 101 Mountain Lakes NJ 07046-1742 Ph: (973) 321-4380 | Inner Wellth LLC 420 Boulevard Suite 101 Mountain Lakes NJ 07046-1742 Ph: (973) 321-4380 |
| NPI Number | 1992077622 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 01/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992077622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 35SI00473800 (New Jersey) | Primary |
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