Provider Demographics
NPI:1891552808
Name:WELLNESS SERVICES HEALTHCARE GROUP
Entity Type:Organization
Organization Name:WELLNESS SERVICES HEALTHCARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:RURENGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-614-5384
Mailing Address - Street 1:525 PAWTUCKET BLVD UNIT 503
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2957
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 PAWTUCKET BLVD UNIT 503
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2957
Practice Address - Country:US
Practice Address - Phone:978-614-5384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care