Provider Demographics
NPI:1427477207
Name:WELLINGTON INSTITUTE, INC.
Entity type:Organization
Organization Name:WELLINGTON INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:DINKINS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, NCP, BCPC,
Authorized Official - Phone:601-720-1671
Mailing Address - Street 1:227 ROUSER RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-5060
Mailing Address - Country:US
Mailing Address - Phone:601-853-3688
Mailing Address - Fax:601-321-9849
Practice Address - Street 1:5360 EXECUTIVE PL
Practice Address - Street 2:BUILDING C
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4101
Practice Address - Country:US
Practice Address - Phone:601-321-9849
Practice Address - Fax:601-321-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health