Provider Demographics
NPI:1083352934
Name:COMMUNITY WELLNESS CENTRE
Entity Type:Organization
Organization Name:COMMUNITY WELLNESS CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA, CDC RECOGNIZED
Authorized Official - Phone:513-470-4163
Mailing Address - Street 1:3117 W TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3411
Mailing Address - Country:US
Mailing Address - Phone:513-470-4163
Mailing Address - Fax:
Practice Address - Street 1:5545 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-3188
Practice Address - Country:US
Practice Address - Phone:740-280-9650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-21
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty