Provider Demographics
NPI:1346985512
Name:WEBSTER WELLNESS L.L.C.
Entity Type:Organization
Organization Name:WEBSTER WELLNESS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-999-4539
Mailing Address - Street 1:2820 S ALMA SCHOOL RD STE 18
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4394
Mailing Address - Country:US
Mailing Address - Phone:480-999-4539
Mailing Address - Fax:480-696-1997
Practice Address - Street 1:44265 W ROTH RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-8474
Practice Address - Country:US
Practice Address - Phone:480-999-4539
Practice Address - Fax:480-696-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health