Organization
WELLLIFE NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI ALAMEDA (CFO)
(347) 542-5616
Entity
Organization
Contact information
Practice address
8806 195TH PL, HOLLIS, NY 11423-2029
(718) 776-0280
Mailing address
2244 119TH ST, COLLEGE POINT, NY 11356-2516
(718) 445-4700
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
01116678
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01116678
—
NY
Enumeration date
12/20/2006
Last updated
12/16/2020
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