Healthcare Provider Details
I. General information
NPI: 1205349198
Provider Name (Legal Business Name): WELLNESS WAY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2017
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1385 S COLORADO BLVD STE 306
DENVER CO
80222-3315
US
IV. Provider business mailing address
1385 S COLORADO BLVD STE 306
DENVER CO
80222-3315
US
V. Phone/Fax
- Phone: 303-722-2208
- Fax: 303-722-4411
- Phone: 303-722-2208
- Fax: 303-722-4411
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 1004L0 |
| License Number State | CO |
VIII. Authorized Official
Name:
CHRISTOPHER
MAESTAS
Title or Position: GENERAL MANAGER
Credential:
Phone: 303-722-2208