Provider Demographics
NPI:1336774397
Name:REED WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:REED WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-698-3401
Mailing Address - Street 1:8 1/2 CANTY LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-2624
Mailing Address - Country:US
Mailing Address - Phone:618-698-3401
Mailing Address - Fax:
Practice Address - Street 1:8 1/2 CANTY LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-2624
Practice Address - Country:US
Practice Address - Phone:618-698-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REED WELLNESS CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty