Provider Demographics
NPI:1831804400
Name:HELLO WONDERWORK INC.
Entity type:Organization
Organization Name:HELLO WONDERWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KALKIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-402-8736
Mailing Address - Street 1:5214F DIAMOND HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2175
Mailing Address - Country:US
Mailing Address - Phone:415-915-6556
Mailing Address - Fax:
Practice Address - Street 1:235 IRONWORKS AVE
Practice Address - Street 2:UNIT #473
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544
Practice Address - Country:US
Practice Address - Phone:415-915-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health