Healthcare Provider Details

I. General information

NPI: 1548171382
Provider Name (Legal Business Name): A PURER DASANIS WELLNESS HOUSE L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 E TANNERS CREEK DR APT 5
NORFOLK VA
23513-1161
US

IV. Provider business mailing address

1372 E TANNERS CREEK DR APT 5
NORFOLK VA
23513-1161
US

V. Phone/Fax

Practice location:
  • Phone: 347-575-8765
  • Fax:
Mailing address:
  • Phone: 347-575-8765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MISS DASANI A WILKERSN
Title or Position: CEO/ OWNER
Credential:
Phone: 347-575-8765