Provider Demographics
NPI:1780068163
Name:WELL MANAGED CARE LLC
Entity type:Organization
Organization Name:WELL MANAGED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EBB
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:443-455-0357
Mailing Address - Street 1:2853 STRAUSS TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2853 STRAUSS TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7148
Practice Address - Country:US
Practice Address - Phone:443-455-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1020205251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management