Provider Demographics
NPI:1184363665
Name:HOUSE OF WELLNESS LLC
Entity type:Organization
Organization Name:HOUSE OF WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-328-6163
Mailing Address - Street 1:4546 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5204
Mailing Address - Country:US
Mailing Address - Phone:954-662-0500
Mailing Address - Fax:
Practice Address - Street 1:4546 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5204
Practice Address - Country:US
Practice Address - Phone:954-662-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONPOINT MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-02
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty