Provider Demographics
NPI:1104587898
Name:FAMILY WHOLENESS & WELLNESS LLC
Entity type:Organization
Organization Name:FAMILY WHOLENESS & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:EWELINA
Authorized Official - Last Name:DECOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:732-881-4136
Mailing Address - Street 1:323 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2476
Mailing Address - Country:US
Mailing Address - Phone:732-881-4136
Mailing Address - Fax:
Practice Address - Street 1:323 MAIN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2476
Practice Address - Country:US
Practice Address - Phone:732-881-4136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy