Provider Demographics
NPI:1568161230
Name:CATER WELLNESS & OUTREACH CENTER LLC
Entity Type:Organization
Organization Name:CATER WELLNESS & OUTREACH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-714-0520
Mailing Address - Street 1:7225 HANOVER PARKER
Mailing Address - Street 2:STE C
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:240-391-6588
Mailing Address - Fax:
Practice Address - Street 1:7225 HANOVER PARKER
Practice Address - Street 2:STE C
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:240-391-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care