Provider Demographics
NPI:1770310617
Name:WELLNESS HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:WELLNESS HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:PAYE
Authorized Official - Suffix:
Authorized Official - Credentials:TMA/CNA
Authorized Official - Phone:202-460-7311
Mailing Address - Street 1:113 BROADWAY AVE N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-3720
Mailing Address - Country:US
Mailing Address - Phone:507-206-0840
Mailing Address - Fax:507-206-0318
Practice Address - Street 1:113 BROADWAY AVE N
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-3720
Practice Address - Country:US
Practice Address - Phone:507-206-0840
Practice Address - Fax:507-206-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care