Healthcare Provider Details

I. General information

NPI: 1538763933
Provider Name (Legal Business Name): WELLS HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 PEBBLE HEIGHTS LN
SUGAR LAND TX
77479-3753
US

IV. Provider business mailing address

3906 PEBBLE HEIGHTS LN
SUGAR LAND TX
77479-3753
US

V. Phone/Fax

Practice location:
  • Phone: 907-351-4814
  • Fax:
Mailing address:
  • Phone: 907-351-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ISICHEI S ANENE
Title or Position: ADMINISTRATOR
Credential:
Phone: 907-351-4814