Provider Demographics
NPI:1154712271
Name:WELLNESS NETWORKS, INC
Entity type:Organization
Organization Name:WELLNESS NETWORKS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT- PROGRAMS AND OPERAT
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MILLBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:313-446-9800
Mailing Address - Street 1:3011 W GRAND BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3096
Mailing Address - Country:US
Mailing Address - Phone:313-446-9800
Mailing Address - Fax:313-446-9839
Practice Address - Street 1:3011 W GRAND BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3096
Practice Address - Country:US
Practice Address - Phone:313-446-9800
Practice Address - Fax:313-446-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801017866251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health