Provider Demographics
NPI:1518222793
Name:WELLNESS HEALTH SYSTEMS CORP
Entity Type:Organization
Organization Name:WELLNESS HEALTH SYSTEMS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-300-9450
Mailing Address - Street 1:10250 NW 46TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7902
Mailing Address - Country:US
Mailing Address - Phone:186-655-9854
Mailing Address - Fax:954-626-0161
Practice Address - Street 1:10250 NW 46TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7902
Practice Address - Country:US
Practice Address - Phone:186-655-9854
Practice Address - Fax:954-626-0161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BSSN ADMINISTRATIVE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)