Provider Demographics
NPI:1962234757
Name:COMMUNITY WELLNESS AND INTERVENTION
Entity type:Organization
Organization Name:COMMUNITY WELLNESS AND INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEONKEI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIVNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-278-1292
Mailing Address - Street 1:3433 AGLER RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3397
Mailing Address - Country:US
Mailing Address - Phone:216-278-1292
Mailing Address - Fax:
Practice Address - Street 1:3433 AGLER RD STE 2000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3397
Practice Address - Country:US
Practice Address - Phone:216-278-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health