Provider Demographics
NPI:1891271409
Name:WELL CARE HOME CARE LLC
Entity Type:Organization
Organization Name:WELL CARE HOME CARE LLC
Other - Org Name:WECARE BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLATUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUMUYIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-281-4449
Mailing Address - Street 1:136 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1330
Mailing Address - Country:US
Mailing Address - Phone:320-281-4449
Mailing Address - Fax:
Practice Address - Street 1:136 DIVISION ST
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1330
Practice Address - Country:US
Practice Address - Phone:651-621-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health