Provider Demographics
NPI:1679679203
Name:THE WELLNESS CONNECTION - A HOME CARE AGENCY
Entity Type:Organization
Organization Name:THE WELLNESS CONNECTION - A HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:614-734-9810
Mailing Address - Street 1:611 E WEBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1097
Mailing Address - Country:US
Mailing Address - Phone:614-447-1746
Mailing Address - Fax:614-447-8329
Practice Address - Street 1:611 E WEBER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1097
Practice Address - Country:US
Practice Address - Phone:614-447-1746
Practice Address - Fax:614-447-8329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368011251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2366783Medicaid
OH2366783Medicaid