Provider Demographics
NPI:1518418904
Name:TH-WELLNESS LLC
Entity Type:Organization
Organization Name:TH-WELLNESS LLC
Other - Org Name:TH WELLNESS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-8868
Mailing Address - Street 1:721 LINCOLN WAY E
Mailing Address - Street 2:SUITE B
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6829
Mailing Address - Country:US
Mailing Address - Phone:561-244-8868
Mailing Address - Fax:561-244-8055
Practice Address - Street 1:721 LINCOLN WAY E
Practice Address - Street 2:SUITE B
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6829
Practice Address - Country:US
Practice Address - Phone:561-244-8868
Practice Address - Fax:561-244-8055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TH WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-20
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty