Provider Demographics
NPI:1053080432
Name:WELLNEST HEALTH SYSTEMS INCORPORTED
Entity Type:Organization
Organization Name:WELLNEST HEALTH SYSTEMS INCORPORTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSIBAU
Authorized Official - Middle Name:OMOTOSHO
Authorized Official - Last Name:ADEBAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-718-0552
Mailing Address - Street 1:3 MILL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6501
Mailing Address - Country:US
Mailing Address - Phone:410-718-0552
Mailing Address - Fax:410-205-7092
Practice Address - Street 1:3 MILL CREEK CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6501
Practice Address - Country:US
Practice Address - Phone:410-718-0552
Practice Address - Fax:410-205-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities