Organization
IM SO YOGA
Active
Other names
Im So Yoga Newark
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE L HERNANDEZ 8YR YOGA INSTRUCTOR (CEO)
(862) 236-3376
Entity
Organization
Contact information
Practice address
1186 RAYMOND BLVD FL 4, NEWARK, NJ 07102-4108
(862) 236-3376
Mailing address
15 WARREN ST APT 2, NEWARK, NJ 07102-3089
(973) 495-5255
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
302R00000X
Health Maintenance Organization
—
—
305R00000X
Preferred Provider Organization
Primary
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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