MEDICARE: SDWELLNESSCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1174311690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SDWELLNESSCARE

Provider Business Mailing Address
First Line	:	15 HILL RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-4603
Country	:	US
Telephone Number	:	763-415-2340
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 HILL RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-4603
Country	:	US
Telephone Number	:	763-415-2340
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ZAINAB SESAY
Credential	:
Telephone Number	:	763-415-2340

Provider Enumeration Date	:	04/25/2025
Last Update Date	:	04/29/2025

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Directions to “SDWELLNESSCARE ” Practice Location

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