Provider Demographics
NPI:1689114274
Name:HOUSE OF WELLNESS INC
Entity Type:Organization
Organization Name:HOUSE OF WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:863-453-4161
Mailing Address - Street 1:930 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-3312
Mailing Address - Country:US
Mailing Address - Phone:863-453-4161
Mailing Address - Fax:
Practice Address - Street 1:930 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-3312
Practice Address - Country:US
Practice Address - Phone:863-453-4161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27280175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty