Provider Demographics
NPI:1356668230
Name:WELLNESS & THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:WELLNESS & THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUMOKE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:ABEGUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, OTR/L
Authorized Official - Phone:562-500-1201
Mailing Address - Street 1:8981 W SAHARA AVE
Mailing Address - Street 2:STE. 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5897
Mailing Address - Country:US
Mailing Address - Phone:562-500-1201
Mailing Address - Fax:800-610-5973
Practice Address - Street 1:8981 W SAHARA AVE
Practice Address - Street 2:STE. 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5897
Practice Address - Country:US
Practice Address - Phone:562-500-1201
Practice Address - Fax:800-610-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV09-0195225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1467785071OtherEARLY INTERVENTION PROVIDER AGENCY