Organization
CENTER FOR BEHAVIORAL HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN PABLO PENALOZA MD (OWNER)
(516) 499-9128
Entity
Organization
Contact information
Practice address
810 ABBOTT BLVD STE 204, FORT LEE, NJ 07024-4116
(516) 499-9128
(516) 794-6080
Mailing address
1873 ALBERMARLE AVE, EAST MEADOW, NY 11554
(516) 499-9128
(516) 794-6080
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/01/2014
Last updated
02/29/2016
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