Provider Demographics
NPI:1770180630
Name:WISDOM 7, LLC
Entity Type:Organization
Organization Name:WISDOM 7, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TEKEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-502-9751
Mailing Address - Street 1:87 W MARCH LN STE 1
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5731
Mailing Address - Country:US
Mailing Address - Phone:833-502-9751
Mailing Address - Fax:
Practice Address - Street 1:87 W MARCH LN STE 1
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5731
Practice Address - Country:US
Practice Address - Phone:833-502-9751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health