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General NPI Number Information
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NPI Number | 1376901827
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Entity Type | Organization
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Legal Business Name | CWA ENTERPRISES
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 2885 SANFORD AVE SW # 36433
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City | GRANDVILLE
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State | MI
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Zip | 49418-1342
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Country | US
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Telephone | 616-378-6814
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Fax | 931-815-8887
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Provider Business Mailing Address
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Address Line | 2885 SANFORD AVE SW # 36433
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City | GRANDVILLE
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State | MI
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Zip | 49418-1342
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Country | US
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Telephone | 616-378-6814
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Fax | 931-815-8887
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Authorized Official
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Title or Position | CEO
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Name | MR. C WAYNE ALLEN JR.
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Credential | MHA, RHIA, CCS, MBA
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Telephone | 615-379-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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