Provider Demographics
NPI:1770472672
Name:ATWELLS WELLNESS CENTER LLC
Entity type:Organization
Organization Name:ATWELLS WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ATWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-709-7147
Mailing Address - Street 1:PSC 557 BOX 2432
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379-0025
Mailing Address - Country:US
Mailing Address - Phone:267-709-7147
Mailing Address - Fax:
Practice Address - Street 1:5115 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-4003
Practice Address - Country:US
Practice Address - Phone:267-709-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty