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General NPI Number Information
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NPI Number | 1083003453
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Entity Type | Organization
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Legal Business Name | THE WELLCARE GROUP, LLC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 04/10/2015
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Provider Practice Location Address
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Address Line | 201 S FRONT ST
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City | CHESANING
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State | MI
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Zip | 48616-1328
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Country | US
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Telephone | 989-845-6602
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Fax | 989-845-4719
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Provider Business Mailing Address
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Address Line | 46036 MICHIGAN AVE SUITE 108
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City | CANTON
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State | MI
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Zip | 48188-2304
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Country | US
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Telephone | 734-834-7377
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | AMEE PATEL
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Credential |
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Telephone | 734-834-7377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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