Provider Demographics
NPI:1528661782
Name:HEALTH & WELLNESS 365 LLC
Entity type:Organization
Organization Name:HEALTH & WELLNESS 365 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MEKELLA
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC, CDCES
Authorized Official - Phone:916-827-0463
Mailing Address - Street 1:2404 KINSELLA WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-9178
Mailing Address - Country:US
Mailing Address - Phone:561-929-6244
Mailing Address - Fax:
Practice Address - Street 1:2404 KINSELLA WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-9574
Practice Address - Country:US
Practice Address - Phone:561-929-6244
Practice Address - Fax:918-398-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty