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General NPI Number Information
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NPI Number | 1376784009
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Entity Type | Organization
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Legal Business Name | WELLNESS HOME HEALTH AGENCY LLC
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 1704 SPRINGS RD SUITE B
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City | VALLEJO
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State | CA
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Zip | 94591-5475
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Country | US
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Telephone | 707-643-2879
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Fax | 707-643-4028
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Provider Business Mailing Address
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Address Line | 1704 SPRINGS RD
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City | VALLEJO
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State | CA
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Zip | 94591-5474
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Country | US
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Telephone | 707-643-2879
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Fax | 707-643-4028
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Authorized Official
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Title or Position | CEO
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Name | MR. EMERLINO R. MANAID
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Credential |
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Telephone | 707-643-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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