Provider Demographics
NPI:1114763182
Name:WELLNESS AT HOMES CARE SERVICES LLC
Entity type:Organization
Organization Name:WELLNESS AT HOMES CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:TOLULOPE
Authorized Official - Last Name:OWOSENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-770-7087
Mailing Address - Street 1:2803 BAINBRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8830
Mailing Address - Country:US
Mailing Address - Phone:817-770-7087
Mailing Address - Fax:
Practice Address - Street 1:2803 BAINBRIDGE TRL
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8830
Practice Address - Country:US
Practice Address - Phone:817-770-7087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty