Healthcare Provider Details

I. General information

NPI: 1558844506
Provider Name (Legal Business Name): NEW HEIGHTS WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7049 TAYLORSVILLE RD STE A
HUBER HEIGHTS OH
45424-3190
US

IV. Provider business mailing address

7049 TAYLORSVILLE RD STE A
HUBER HEIGHTS OH
45424-3190
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-1755
  • Fax: 937-233-1655
Mailing address:
  • Phone: 937-233-1755
  • Fax: 937-233-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MALISSA L TRACY
Title or Position: OWNER/PRACTITIONER
Credential: LMT
Phone: 937-233-1755