Provider Demographics
NPI:1194341271
Name:ATARAH HEALTH & WELLNESS, LLC
Entity type:Organization
Organization Name:ATARAH HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ST. ROMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-359-6067
Mailing Address - Street 1:8449 W BELLFORT ST STE 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2247
Mailing Address - Country:US
Mailing Address - Phone:832-203-5096
Mailing Address - Fax:832-519-9726
Practice Address - Street 1:8449 W BELLFORT ST STE 330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2247
Practice Address - Country:US
Practice Address - Phone:832-203-5096
Practice Address - Fax:832-519-9726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service