Provider Demographics
NPI:1083348668
Name:KAI WELLNESS CENTER
Entity Type:Organization
Organization Name:KAI WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ULRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ACCIME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-283-7159
Mailing Address - Street 1:2679 NW 60TH WAY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2230
Mailing Address - Country:US
Mailing Address - Phone:954-283-7159
Mailing Address - Fax:
Practice Address - Street 1:2679 NW 60TH WAY
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2230
Practice Address - Country:US
Practice Address - Phone:954-283-7159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty