Provider Demographics
NPI:1700427994
Name:WELLNESS HOME CARE
Entity Type:Organization
Organization Name:WELLNESS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OHENEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:NTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-667-2273
Mailing Address - Street 1:2304 BERLIN TPKE STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3204
Mailing Address - Country:US
Mailing Address - Phone:860-667-2273
Mailing Address - Fax:
Practice Address - Street 1:2304 BERLIN TPKE STE 202
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3204
Practice Address - Country:US
Practice Address - Phone:860-667-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health