Provider Demographics
NPI:1154956076
Name:WELLNESS CENTER FOR ALL
Entity type:Organization
Organization Name:WELLNESS CENTER FOR ALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NASRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-649-1230
Mailing Address - Street 1:1166 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5442 HAYDEN STATION WAY APT 136
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7562
Practice Address - Country:US
Practice Address - Phone:614-815-9694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No305S00000XManaged Care OrganizationsPoint of Service
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No347C00000XTransportation ServicesPrivate Vehicle