Provider Demographics
NPI:1245746148
Name:COMMUNITY WELLNESS, INC.
Entity Type:Organization
Organization Name:COMMUNITY WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:CCM
Authorized Official - Phone:954-951-7997
Mailing Address - Street 1:4996 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5338
Mailing Address - Country:US
Mailing Address - Phone:954-951-7997
Mailing Address - Fax:
Practice Address - Street 1:4996 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5338
Practice Address - Country:US
Practice Address - Phone:954-951-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management