Organization
DANCING GODDESS RISING MINISTRIES, LLC
Active
Other names
Awakening Heart Wellness Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRA LYNN JULIANO LCSW (CHIEF EXECUTIVE OFFICER)
(516) 426-2700
Entity
Organization
Contact information
Practice address
21 E 2ND ST, SUITE 101, RIVERHEAD, NY 11901-4616
(516) 426-2700
Mailing address
21 E 2ND STREET, SUITE 101, RIVERHEAD, NY 11901
(516) 426-2700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0829261
NY
Other
Enumeration date
08/12/2015
Last updated
03/29/2017
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