Provider Demographics
NPI:1376012401
Name:WELLS HOUSE INC
Entity Type:Organization
Organization Name:WELLS HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRENTON NEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-739-7748
Mailing Address - Street 1:124 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6104
Mailing Address - Country:US
Mailing Address - Phone:301-739-7748
Mailing Address - Fax:
Practice Address - Street 1:324 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4059
Practice Address - Country:US
Practice Address - Phone:301-739-7748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder