Provider Demographics
NPI:1477316966
Name:COMMUNITY WELLNESS AND INTERVENTION
Entity Type:Organization
Organization Name:COMMUNITY WELLNESS AND INTERVENTION
Other - Org Name:COMMUNITY TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEONKEI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIVNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-500-4150
Mailing Address - Street 1:951 YORK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2052
Mailing Address - Country:US
Mailing Address - Phone:216-278-1292
Mailing Address - Fax:
Practice Address - Street 1:951 YORK DR STE 104
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2052
Practice Address - Country:US
Practice Address - Phone:216-278-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty