Provider Demographics
NPI:1932428646
Name:WELLNESS FIRST HOME HEALTH CARE
Entity Type:Organization
Organization Name:WELLNESS FIRST HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:HICKS
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-823-3005
Mailing Address - Street 1:1269 WETLANDS CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6255
Mailing Address - Country:US
Mailing Address - Phone:678-823-3005
Mailing Address - Fax:678-935-0235
Practice Address - Street 1:1269 WETLANDS CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6255
Practice Address - Country:US
Practice Address - Phone:678-823-3005
Practice Address - Fax:678-935-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN063632251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health