Provider Demographics
NPI:1124763008
Name:NEW POSSIBILITIES WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:NEW POSSIBILITIES WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-274-2005
Mailing Address - Street 1:1767 HIGHWAY 395 S
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-9703
Mailing Address - Country:US
Mailing Address - Phone:928-274-2005
Mailing Address - Fax:
Practice Address - Street 1:1767 HIGHWAY 395 S
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-9703
Practice Address - Country:US
Practice Address - Phone:928-274-2005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETSY HENRY, OTR/L
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty