# CLASSIC WELLNESS FAMILY MENTAL HEALTH PRACTICE LLC

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

## Provider details

- **NPI number:** 1801427810
- **Authorized official:** CHINENYE OKORO DNP APN (CEO)
- **Authorized official phone:** (718) 325-4669

## Contact information

- **Practice address:** 540 NORTH AVE STE 3, UNION, NJ 07083-7149
- **Practice address phone:** (718) 325-4669
- **Mailing address:** 1220 VICTOR AVE, UNION, NJ 07083-3706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2020
- **Last updated:** 01/29/2020