Provider Demographics
NPI:1639113319
Name:ECHN WELLNESS SERVICES, INC.
Entity Type:Organization
Organization Name:ECHN WELLNESS SERVICES, INC.
Other - Org Name:WOMEN'S CENTER FOR WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-646-1222
Mailing Address - Street 1:2800 TAMARACK DRIVE
Mailing Address - Street 2:SUITE 001
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074
Mailing Address - Country:US
Mailing Address - Phone:860-533-4646
Mailing Address - Fax:
Practice Address - Street 1:2800 TAMARACK DRIVE
Practice Address - Street 2:SUITE 001
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074
Practice Address - Country:US
Practice Address - Phone:860-533-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0197261Q00000X
CT0442261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology