Provider Demographics
NPI:1891384954
Name:UNITED HEALTH & WELLNESS DETOX, INC
Entity type:Organization
Organization Name:UNITED HEALTH & WELLNESS DETOX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LUISA
Authorized Official - Last Name:WAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-342-8999
Mailing Address - Street 1:3212 SHRINE RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4353
Mailing Address - Country:US
Mailing Address - Phone:912-342-8999
Mailing Address - Fax:912-342-7541
Practice Address - Street 1:3212 SHRINE RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4353
Practice Address - Country:US
Practice Address - Phone:912-342-8999
Practice Address - Fax:912-342-7541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility