Provider Demographics
NPI:1821587064
Name:WELLESLEY WELLNESS, LLC
Entity Type:Organization
Organization Name:WELLESLEY WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:O'GARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-705-6040
Mailing Address - Street 1:36 WASHINGTON ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1910
Mailing Address - Country:US
Mailing Address - Phone:781-705-6040
Mailing Address - Fax:781-705-6026
Practice Address - Street 1:36 WASHINGTON ST STE 130
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1910
Practice Address - Country:US
Practice Address - Phone:781-705-6040
Practice Address - Fax:781-705-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)