Provider Demographics
NPI:1306309802
Name:THE CENTER FOR WELLNESS ENCOUNTERS
Entity type:Organization
Organization Name:THE CENTER FOR WELLNESS ENCOUNTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:AVETTA
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-753-5589
Mailing Address - Street 1:2121 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2926
Mailing Address - Country:US
Mailing Address - Phone:224-307-4124
Mailing Address - Fax:
Practice Address - Street 1:2121 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2926
Practice Address - Country:US
Practice Address - Phone:224-307-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty