Provider Demographics
NPI:1891485439
Name:WEST CASCADE WELLNESS CENTER
Entity Type:Organization
Organization Name:WEST CASCADE WELLNESS CENTER
Other - Org Name:BRAIN AND BODILY INJURY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARHEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:404-539-7976
Mailing Address - Street 1:3910 CASCADE RD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-7240
Mailing Address - Country:US
Mailing Address - Phone:404-539-7976
Mailing Address - Fax:404-699-0988
Practice Address - Street 1:3910 CASCADE RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-7240
Practice Address - Country:US
Practice Address - Phone:404-539-7976
Practice Address - Fax:404-699-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty