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Organization
GENERATIONAL WELLNESS CENTER
Active
Organization
GENERATIONAL WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANILL MEDINA LMFT (OWNER, CEO)
(201) 357-9885
Entity
Organization
Contact information
Practice address
121 CEDAR LN STE 102, TEANECK, NJ 07666-4457
(201) 357-9885
Mailing address
121 CEDAR LN STE 102, TEANECK, NJ 07666-4457
(201) 357-9885
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
Other
Enumeration date
04/10/2026
Last updated
08/13/2026
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