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General NPI Number Information
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NPI Number | 1710445663
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Entity Type | Organization
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Legal Business Name | GLOBAL WELLNESS CENTER LLC
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 3350 CLEVELAND AVE STE 1964
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City | COLUMBUS
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State | OH
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Zip | 43224-3677
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Country | US
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Telephone | 614-588-9830
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 TILLER LN STE 107
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City | COLUMBUS
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State | OH
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Zip | 43231-2267
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Country | US
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Telephone | 614-588-9830
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YASSIN MATAN
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Credential |
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Telephone | 614-588-9830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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