Provider Demographics
NPI:1245695576
Name:BACK TO NATURE HEALTH AND WELLNESS CENTER
Entity type:Organization
Organization Name:BACK TO NATURE HEALTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:810-620-6706
Mailing Address - Street 1:G3380 BEECHER RD STE A
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3647
Mailing Address - Country:US
Mailing Address - Phone:810-733-1415
Mailing Address - Fax:810-733-1416
Practice Address - Street 1:G3380 BEECHER RD STE A
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3647
Practice Address - Country:US
Practice Address - Phone:810-733-1415
Practice Address - Fax:810-733-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty