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General NPI Number Information
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NPI Number | 1578320131
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Entity Type | Organization
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Legal Business Name | WELL ROOTED HEALTH
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Dates
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Enumeration Date | 02/29/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 17 WILSON ST
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City | BIDDEFORD
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State | ME
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Zip | 04005-3811
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Country | US
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Telephone | 302-722-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 17 WILSON ST
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City | BIDDEFORD
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State | ME
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Zip | 04005-3811
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Country | US
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Telephone | 302-722-7002
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LAURA LOUISE KUHS
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Credential |
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Telephone | 302-722-7002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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