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General NPI Number Information
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NPI Number | 1568028751
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Entity Type | Organization
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Legal Business Name | RIGHT WAY WELLNESS CENTER LLC
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 4757 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60641-1504
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Country | US
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Telephone | 954-805-0177
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Fax | 888-293-5884
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Provider Business Mailing Address
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Address Line | 1225 E RIVER DR
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City | MARGATE
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State | FL
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Zip | 33063-3635
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Country | US
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Telephone | 954-805-0177
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Fax | 888-293-5884
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Authorized Official
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Title or Position | CEO
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Name | MS. VAN JONES
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Credential | MS, EDD, MCAP
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Telephone | 954-805-0177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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