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General NPI Number Information
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NPI Number | 1346096047
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Entity Type | Organization
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Legal Business Name | THE WELLNESS CLINIC L.L.C.
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3333 W DIVISION ST STE 218-5
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4515
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Country | US
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Telephone | 651-354-5895
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Fax | 320-373-8770
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Provider Business Mailing Address
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Address Line | 3333 W DIVISION ST STE 218-5
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4515
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Country | US
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Telephone | 651-354-5895
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Fax | 320-373-8770
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. FAYSEL AHMED ALI
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Credential |
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Telephone | 651-354-5895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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