New Roads Wellness Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEW ROADS WELLNESS CENTER, LLC

Practice address

2911 Dixwell Ave # B10
Hamden, CT 06518-3195

Phone

(203) 821-7390

NPI assigned

Apr 14, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charmaine Wallen

Title

Owner/Manager

Phone

(718) 669-4113

Specialties & licenses 1

Addresses

Other names 1

• New Roads Wellness Center, LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523664000000",
    "number": "1578050605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 COUNTRY HILLS RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143217",
            "telephone_number": "718-669-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 DIXWELL AVE # B10",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183195",
            "telephone_number": "203-821-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ROADS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-14",
        "last_updated": "2018-04-14",
        "status": "A",
        "authorized_official_last_name": "WALLEN",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "718-669-4113"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Roads Wellness Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.