Healthcare Provider Details

I. General information

NPI: 1285421263
Provider Name (Legal Business Name): WELLNESS CENTER ARMHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 REANEY AVE E
SAINT PAUL MN
55119-3427
US

IV. Provider business mailing address

1803 REANEY AVE E
SAINT PAUL MN
55119-3427
US

V. Phone/Fax

Practice location:
  • Phone: 651-500-1582
  • Fax: 651-384-7148
Mailing address:
  • Phone: 651-500-1582
  • Fax: 651-384-7148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSELINE YANG
Title or Position: TREATMENT SUPERVISOR
Credential: NP
Phone: 651-500-1572