Provider Demographics
NPI:1093180044
Name:THE WELLNESS PLAN
Entity Type:Organization
Organization Name:THE WELLNESS PLAN
Other - Org Name:WELLNESS PLAN EAST URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-202-8550
Mailing Address - Street 1:7700 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2411
Mailing Address - Country:US
Mailing Address - Phone:313-202-8660
Mailing Address - Fax:
Practice Address - Street 1:4909 E OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3446
Practice Address - Country:US
Practice Address - Phone:313-366-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M37210Medicare PIN