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General NPI Number Information
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NPI Number | 1548434194
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Entity Type | Organization
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Legal Business Name | WELLCARE, INC.
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 218 MAIN ST
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City | PARIS
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State | KY
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Zip | 40361-2004
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Country | US
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Telephone | 859-987-0586
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Fax |
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Provider Business Mailing Address
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Address Line | 218 MAIN ST
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City | PARIS
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State | KY
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Zip | 40361-2004
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Country | US
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Telephone | 859-987-0586
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MARY B CHEEK
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Credential | R.N.
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Telephone | 859-987-0586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 101YM0800X
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License Number State | KY
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