# INSTITUTE OF ETERNAL WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154694511
- **Authorized official:** MISS SHANIKA MALCOLM RYT, RM, ND (CEO)
- **Authorized official phone:** (267) 266-1320

## Contact information

- **Practice address:** 2522 S BELLFORD ST, PHILADELPHIA, PA 19153-1411
- **Practice address phone:** (267) 266-1320
- **Mailing address:** 2522 S BELLFORD ST, PHILADELPHIA, PA 19153-1411
- **Mailing address phone:** (267) 266-1320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 374J00000X | Doula | — | NULL | Yes |
| 374J00000X | Doula | — | — | Yes |
| 374K00000X | Religious Nonmedical Practitioner | — | NULL | — |
| 374K00000X | Religious Nonmedical Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/15/2012
- **Last updated:** 02/15/2012