Provider Demographics
NPI:1033888516
Name:JOURNEY TO WELLNESS
Entity Type:Organization
Organization Name:JOURNEY TO WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-361-0285
Mailing Address - Street 1:15155 KATY FWY APT 314
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1907
Mailing Address - Country:US
Mailing Address - Phone:832-361-0285
Mailing Address - Fax:
Practice Address - Street 1:15155 KATY FWY APT 314
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1907
Practice Address - Country:US
Practice Address - Phone:832-361-0285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health