Healthcare Provider Details

I. General information

NPI: 1073821468
Provider Name (Legal Business Name): WELIA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SANDY LN
HINCKLEY MN
55037-8381
US

IV. Provider business mailing address

301 HIGHWAY 65 S
MORA MN
55051-1899
US

V. Phone/Fax

Practice location:
  • Phone: 320-384-6189
  • Fax: 320-384-6181
Mailing address:
  • Phone: 320-679-1212
  • Fax: 320-225-3345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMN

VIII. Authorized Official

Name: RANDY ULSETH
Title or Position: CEO
Credential:
Phone: 320-225-3315