Provider Demographics
NPI:1124918966
Name:ENCOMPASS WELLNESS STUDIO LLC
Entity type:Organization
Organization Name:ENCOMPASS WELLNESS STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:L'ESPERANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-910-5885
Mailing Address - Street 1:213 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CALUMET
Mailing Address - State:MI
Mailing Address - Zip Code:49913-1607
Mailing Address - Country:US
Mailing Address - Phone:612-910-5885
Mailing Address - Fax:
Practice Address - Street 1:213 6TH ST
Practice Address - Street 2:
Practice Address - City:CALUMET
Practice Address - State:MI
Practice Address - Zip Code:49913-1607
Practice Address - Country:US
Practice Address - Phone:612-910-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)