Provider Demographics
NPI:1528367851
Name:WELLNESS WORKX LLC
Entity Type:Organization
Organization Name:WELLNESS WORKX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-504-1462
Mailing Address - Street 1:PO BOX 2028
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-2028
Mailing Address - Country:US
Mailing Address - Phone:813-504-1462
Mailing Address - Fax:813-996-9705
Practice Address - Street 1:3632 LAND O LAKES BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-4405
Practice Address - Country:US
Practice Address - Phone:813-504-1462
Practice Address - Fax:813-996-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 2312261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)