Provider Demographics
NPI:1285429985
Name:NCC WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:NCC WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURTADO SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-263-8726
Mailing Address - Street 1:1890 SW 57TH AVE UNIT 1886
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2164
Mailing Address - Country:US
Mailing Address - Phone:786-263-8726
Mailing Address - Fax:
Practice Address - Street 1:1890 SW 57TH AVE UNIT 1886
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2164
Practice Address - Country:US
Practice Address - Phone:786-263-8726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management