Healthcare Provider Details

I. General information

NPI: 1669249728
Provider Name (Legal Business Name): AFTERCARE WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7585 N WOLTERS AVE
FRESNO CA
93720-2672
US

IV. Provider business mailing address

PO BOX 16475
FRESNO CA
93755-6475
US

V. Phone/Fax

Practice location:
  • Phone: 559-644-6696
  • Fax:
Mailing address:
  • Phone: 559-371-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: SANDRA LEE NELSON
Title or Position: OWNER
Credential: RN, CNS, CAC
Phone: 559-371-8823