Provider Demographics
NPI:1629306584
Name:GLOBAL WELLNESS MANAGEMENT COMPANY
Entity Type:Organization
Organization Name:GLOBAL WELLNESS MANAGEMENT COMPANY
Other - Org Name:THE COMMON SENSE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSEBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-893-8900
Mailing Address - Street 1:13150 1ST ST
Mailing Address - Street 2:PO BOX 308
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-9320
Mailing Address - Country:US
Mailing Address - Phone:952-893-8900
Mailing Address - Fax:952-893-7399
Practice Address - Street 1:700 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4401
Practice Address - Country:US
Practice Address - Phone:952-893-8900
Practice Address - Fax:952-893-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4009111N00000X
MN3880111N00000X
MN4190111N00000X
133N00000X, 261QC1500X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy