Healthcare Provider Details

I. General information

NPI: 1871571778
Provider Name (Legal Business Name): WELLNECESSITIES ,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 04/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8835 LINE AVENUE SUITE 400
SHREVEPORT LA
71106-6718
US

IV. Provider business mailing address

8835 LINE AVENUE SUITE 500
SHREVEPORT LA
71106-6718
US

V. Phone/Fax

Practice location:
  • Phone: 318-222-0885
  • Fax: 318-222-0883
Mailing address:
  • Phone: 318-222-0885
  • Fax: 318-222-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEA M DESMARTEAU
Title or Position: CEO /OWNER
Credential:
Phone: 318-222-0885