Healthcare Provider Details

I. General information

NPI: 1043174212
Provider Name (Legal Business Name): AMBIENT WELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24459 SUSSEX HWY
SEAFORD DE
19973-4433
US

IV. Provider business mailing address

PO BOX 1827
SEAFORD DE
19973-8827
US

V. Phone/Fax

Practice location:
  • Phone: 302-629-3099
  • Fax: 302-629-6059
Mailing address:
  • Phone: 302-629-3099
  • Fax: 302-629-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: HELENE Y HENRY
Title or Position: CEO
Credential: FNP-BC
Phone: 410-422-5066