Provider Demographics
NPI:1457865461
Name:WELLCARE SENIOR CENTER LLC
Entity Type:Organization
Organization Name:WELLCARE SENIOR CENTER LLC
Other - Org Name:WELLCARE SENIOR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHI YUK
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-208-7099
Mailing Address - Street 1:3250 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2228
Mailing Address - Country:US
Mailing Address - Phone:281-208-7709
Mailing Address - Fax:281-969-7972
Practice Address - Street 1:3250 WILLIAMSBURG LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2228
Practice Address - Country:US
Practice Address - Phone:713-884-5612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care