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CHANGING TIDES WELLNESS CENTER LLC
NPI 1174304190
Clinic/Center - Mental Health (Including Community Mental Health Center) in Marlton, NJ

Active since October 06, 2023
1000 LINCOLN DR E STE 2, MARLTON, NJ 08053(856) 508-0977 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Changing Tides Wellness Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGING TIDES WELLNESS CENTER LLC (NPI 1174304190) is a healthcare organization registered as a mental health (including community mental health center) in Marlton, New Jersey and active in the NPI registry since October 2023. The organization lists Nicholas Desimone, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1174304190
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCHANGING TIDES WELLNESS CENTER LLC
Location Address1000 LINCOLN DR E STE 2Marlton, NJ 08053-1566
Mailing Address199 North Woodbury Rd.Pitman, NJ 08071 · (856) 508-0977
Phone(856) 508-0977
Organization SubpartNo
Authorized OfficialNicholas DesimoneCeo/owner · (856) 217-9182
Enumeration DateOctober 6, 2023
Last NPPES UpdateNovember 29, 2023
NPPES CertifiedNovember 29, 2023
✔ NPI 1174304190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X
1000 LINCOLN DR E STE 2, Marlton, NJ 08053
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Changing Tides Wellness Center LLC's NPI number?

The NPI number for Changing Tides Wellness Center LLC is 1174304190. It was assigned to this organization in the NPPES registry on October 6, 2023.

Where is Changing Tides Wellness Center LLC located?

Changing Tides Wellness Center LLC is located at 1000 Lincoln Dr E Ste 2, Marlton, NJ 08053. The listed phone number is (856) 508-0977.

What is Changing Tides Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Changing Tides Wellness Center LLC was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.