Provider Demographics
NPI:1487040176
Name:W B WELLNESS, LLC.
Entity Type:Organization
Organization Name:W B WELLNESS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-327-6977
Mailing Address - Street 1:6415 LAKE WORTH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2910
Mailing Address - Country:US
Mailing Address - Phone:561-327-6977
Mailing Address - Fax:888-463-3113
Practice Address - Street 1:6415 LAKE WORTH RD STE 300
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2910
Practice Address - Country:US
Practice Address - Phone:561-327-6977
Practice Address - Fax:888-463-3113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty