Provider Demographics
NPI:1881956233
Name:WELLNESS HOSPICE LLC
Entity type:Organization
Organization Name:WELLNESS HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMERLINO
Authorized Official - Middle Name:R
Authorized Official - Last Name:MANAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-643-2100
Mailing Address - Street 1:1704 SPRINGS RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-5475
Mailing Address - Country:US
Mailing Address - Phone:707-643-2100
Mailing Address - Fax:707-643-4028
Practice Address - Street 1:1704 SPRINGS RD
Practice Address - Street 2:SUITE A
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-5474
Practice Address - Country:US
Practice Address - Phone:707-643-2100
Practice Address - Fax:707-643-4028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based