Provider Demographics
NPI:1841583069
Name:HEALTHWAYS
Entity Type:Organization
Organization Name:HEALTHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/LCC
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-299-7232
Mailing Address - Street 1:14215 DEVINGER PL
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-3717
Mailing Address - Country:US
Mailing Address - Phone:240-299-7232
Mailing Address - Fax:
Practice Address - Street 1:14215 DEVINGER PL
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-3717
Practice Address - Country:US
Practice Address - Phone:240-299-7232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR099957163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty