Provider Demographics
NPI:1699592584
Name:WELLNESS PLUG LLC
Entity type:Organization
Organization Name:WELLNESS PLUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGILE PROJECT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NDUBUEZE
Authorized Official - Middle Name:THANKGOD
Authorized Official - Last Name:ANYADO
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:720-671-2274
Mailing Address - Street 1:1562 S PARKER RD STE 320C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2721
Mailing Address - Country:US
Mailing Address - Phone:720-671-2274
Mailing Address - Fax:
Practice Address - Street 1:1562 S PARKER RD STE 320C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2721
Practice Address - Country:US
Practice Address - Phone:720-671-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS PLUG LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04A356OtherCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
CO04TA2LOtherCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT