Provider Demographics
NPI:1700471620
Name:WELLCHART HEALTH MANAGEMENT
Entity Type:Organization
Organization Name:WELLCHART HEALTH MANAGEMENT
Other - Org Name:GULFSHORE COMPANION CARE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DHA, MHA, LPN
Authorized Official - Phone:239-822-5015
Mailing Address - Street 1:5781 LEE BLVD STE 208-439
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-6337
Mailing Address - Country:US
Mailing Address - Phone:941-313-2435
Mailing Address - Fax:
Practice Address - Street 1:5781 LEE BLVD STE 208-439
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-6337
Practice Address - Country:US
Practice Address - Phone:941-313-2435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No291U00000XLaboratoriesClinical Medical Laboratory
No332U00000XSuppliersHome Delivered MealsGroup - Single Specialty