Provider Demographics
NPI:1740032556
Name:FRESH SOLUTIONS WELLNESS SERVICES INC
Entity type:Organization
Organization Name:FRESH SOLUTIONS WELLNESS SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIMAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:754-213-1619
Mailing Address - Street 1:5245 N UNIVERSITY DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5017
Mailing Address - Country:US
Mailing Address - Phone:754-213-1619
Mailing Address - Fax:954-440-0267
Practice Address - Street 1:5245 N UNIVERSITY DR STE A
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5017
Practice Address - Country:US
Practice Address - Phone:754-213-1619
Practice Address - Fax:954-440-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care