Provider Demographics
NPI: | 1366044398 |
---|---|
Name: | WELLNESS HEALTH SERVICES, LLC |
Entity Type: | Organization |
Organization Name: | WELLNESS HEALTH SERVICES, LLC |
Other - Org Name: | THE ARK OF DC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHAIRWOMAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NADINE |
Authorized Official - Middle Name: | ARNAL |
Authorized Official - Last Name: | TOKO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 202-489-0615 |
Mailing Address - Street 1: | 11202 MARWOOD HILL DR |
Mailing Address - Street 2: | |
Mailing Address - City: | POTOMAC |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20854-1241 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-489-0615 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5900 YORK RD STE 206 |
Practice Address - Street 2: | |
Practice Address - City: | BALTIMORE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21212-3098 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-489-0615 |
Practice Address - Fax: | 202-379-9220 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-11-13 |
Last Update Date: | 2023-07-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 2084P0015X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychosomatic Medicine | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 251E00000X | Agencies | Home Health | Group - Multi-Specialty | |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Single Specialty |
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 364SP0808X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health | Group - Single Specialty |