Organization
WELLLIFE NETWORK INC.
Active
Other names
PSCH INC.
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY TUCKER (CEO)
(718) 559-0534
Entity
Organization
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8302
(631) 920-8462
Mailing address
1985 MARCUS AVE STE 100, NEW HYDE PARK, NY 11042-2025
(718) 559-0516
(718) 762-6140
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02189655
—
NY
Enumeration date
04/03/2008
Last updated
08/16/2024
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