| Organization Name: | LIVE WELL CENTER LLC |
| NPI Number: | 1154633907 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUIS LUNA (MEDICAL DIRECTOR) |
| Mailing Address: | 8 Birchwood Ct Upper Saddle River |
| State: | NJ US |
| Postal Code: | 074581905 |
| Phone Number: | 2019349467 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2010 |
| NPI Last Update Date: | 07/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 35SI00415000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |