Healthcare Provider Details
I. General information
NPI: 1578537023
Provider Name (Legal Business Name): WELIA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2006
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 HIGHWAY 65 S
MORA MN
55051-1899
US
IV. Provider business mailing address
301 HIGHWAY 65 S
MORA MN
55051-1899
US
V. Phone/Fax
- Phone: 320-679-1212
- Fax: 320-225-3345
- Phone: 320-679-1212
- Fax: 320-225-3345
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANDY
ULSETH
Title or Position: CEO
Credential:
Phone: 320-679-1212