Provider Demographics
NPI:1487191201
Name:WELLSHARE INTERNATIONAL
Entity Type:Organization
Organization Name:WELLSHARE INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MIA
Authorized Official - Phone:612-230-3250
Mailing Address - Street 1:122 W FRANKLIN AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2447
Mailing Address - Country:US
Mailing Address - Phone:612-871-3759
Mailing Address - Fax:612-230-3257
Practice Address - Street 1:122 W FRANKLIN AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2447
Practice Address - Country:US
Practice Address - Phone:612-871-3759
Practice Address - Fax:612-230-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty