Provider Demographics
NPI:1407584360
Name:M. WELLS LLC D/B/A INTERIM HEALTHCARE OF CLERMONT
Entity Type:Organization
Organization Name:M. WELLS LLC D/B/A INTERIM HEALTHCARE OF CLERMONT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:WELTY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-221-3130
Mailing Address - Street 1:230 MOHAWK ROAD
Mailing Address - Street 2:SUITES D AND E
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715
Mailing Address - Country:US
Mailing Address - Phone:352-989-5766
Mailing Address - Fax:
Practice Address - Street 1:230 MOHAWK ROAD
Practice Address - Street 2:SUITES D AND E
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715
Practice Address - Country:US
Practice Address - Phone:352-989-5766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health