Healthcare Provider Details

I. General information

NPI: 1144110008
Provider Name (Legal Business Name): WAYMARK HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 HARRISON AVE
ROCKFORD IL
61108-7987
US

IV. Provider business mailing address

101 CRAWFORDS CORNER RD STE 1122
HOLMDEL NJ
07733-1976
US

V. Phone/Fax

Practice location:
  • Phone: 815-201-1877
  • Fax:
Mailing address:
  • Phone: 917-685-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEXANDER UHR
Title or Position: MANAGING MEMBER
Credential:
Phone: 917-685-0713