Provider Demographics
NPI:1033743661
Name:WELLNESS COMMUNITY THERAPY CENTER INC
Entity Type:Organization
Organization Name:WELLNESS COMMUNITY THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAINOA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-615-2306
Mailing Address - Street 1:6955 NW 77TH AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2844
Mailing Address - Country:US
Mailing Address - Phone:786-615-2306
Mailing Address - Fax:786-953-8828
Practice Address - Street 1:6955 NW 77TH AVE STE 407
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2844
Practice Address - Country:US
Practice Address - Phone:786-615-2306
Practice Address - Fax:786-953-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-22
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health