Healthcare Provider Details

I. General information

NPI: 1689594426
Provider Name (Legal Business Name): HELENE ELIZABETH WELLNESS CENTER L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1178 BROADWAY
NEW YORK NY
10001-5404
US

IV. Provider business mailing address

404 ELMWOOD AVE
EAST ORANGE NJ
07018-1102
US

V. Phone/Fax

Practice location:
  • Phone: 347-791-2386
  • Fax:
Mailing address:
  • Phone: 347-791-2386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAVONE SEASE
Title or Position: CEO/FOUNDER
Credential:
Phone: 347-791-2386