Provider Demographics
NPI:1609123678
Name:HEALTHWAYS
Entity Type:Organization
Organization Name:HEALTHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCC
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CWALINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-320-3238
Mailing Address - Street 1:308 BROADWATER RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1435
Mailing Address - Country:US
Mailing Address - Phone:410-626-0328
Mailing Address - Fax:
Practice Address - Street 1:308 BROADWATER RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-1435
Practice Address - Country:US
Practice Address - Phone:410-626-0328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN134075251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management