Provider Demographics
NPI:1669838819
Name:WELLNECESSITIES, INC.
Entity Type:Organization
Organization Name:WELLNECESSITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DESMARTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-222-0885
Mailing Address - Street 1:8835 LINE AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6722
Mailing Address - Country:US
Mailing Address - Phone:318-222-0885
Mailing Address - Fax:318-222-0883
Practice Address - Street 1:2408 DUVAL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2986
Practice Address - Country:US
Practice Address - Phone:318-222-0885
Practice Address - Fax:318-222-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA545224Medicare PIN