Provider Demographics
NPI:1598224636
Name:GREAT WORKS WELLNESS CENTER
Entity Type:Organization
Organization Name:GREAT WORKS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-351-5080
Mailing Address - Street 1:100 OWINGS CT STE 8
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3045
Mailing Address - Country:US
Mailing Address - Phone:443-273-3723
Mailing Address - Fax:443-273-3754
Practice Address - Street 1:100 OWINGS CT STE 8
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-3045
Practice Address - Country:US
Practice Address - Phone:443-273-3723
Practice Address - Fax:443-273-3754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy