Organization
LIFE TRANSFORMATION WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOL SHABAZZ (HEALTH & WELLNESS COACH)
(973) 930-0052
Entity
Organization
Contact information
Practice address
300 E 29TH ST, PATERSON, NJ 07514-1818
(973) 930-0052
Mailing address
300 E 29TH ST, PATERSON, NJ 07514-1818
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WC1500X
Community Health Registered Nurse
—
—
171400000X
Health & Wellness Coach
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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