Provider Demographics
NPI:1508550583
Name:WELLNESS CARE SERVICES LLC
Entity Type:Organization
Organization Name:WELLNESS CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:AGACNP
Authorized Official - Phone:810-656-2208
Mailing Address - Street 1:11041 HENSELL RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8054
Mailing Address - Country:US
Mailing Address - Phone:810-656-2208
Mailing Address - Fax:
Practice Address - Street 1:11041 HENSELL RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-8054
Practice Address - Country:US
Practice Address - Phone:810-656-2208
Practice Address - Fax:810-545-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty