Provider Demographics
NPI:1063779304
Name:ALANI HEALTH & WELLNESS CENTER A NURSING CORPORATION
Entity type:Organization
Organization Name:ALANI HEALTH & WELLNESS CENTER A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:LARITA
Authorized Official - Last Name:SCHMIDT OLAIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:ADULT NP & WHNP
Authorized Official - Phone:310-962-0035
Mailing Address - Street 1:7121 W MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3508
Mailing Address - Country:US
Mailing Address - Phone:424-750-9789
Mailing Address - Fax:424-750-9791
Practice Address - Street 1:7121 W MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3508
Practice Address - Country:US
Practice Address - Phone:424-750-9789
Practice Address - Fax:424-750-9791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6287261Q00000X
CA6509261Q00000X
CA21119261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6509OtherNURSE PRACTITONER LICENSE NUMBER
CA6287OtherNURSE PRACTITONER LICENSE NUMBER
CA21119OtherNURSE PRACTITONER LICENSE NUMBER