Provider Demographics
NPI:1992386601
Name:MEND AND KURE WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:MEND AND KURE WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HHP AND COACH
Authorized Official - Prefix:DR
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-204-4391
Mailing Address - Street 1:2266 N PROSPECT AVE STE 522
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6306
Mailing Address - Country:US
Mailing Address - Phone:262-320-8411
Mailing Address - Fax:
Practice Address - Street 1:2266 N PROSPECT AVE STE 522
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-6306
Practice Address - Country:US
Practice Address - Phone:262-320-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty