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General NPI Number Information
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NPI Number | 1821850769
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Entity Type | Organization
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Legal Business Name | WELL BRAIN AND BODY MENTAL HEALTH AND NURSING CORPORATION
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 353 LEXINGTON AVE FL 4
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City | NEW YORK
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State | NY
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Zip | 10016-0941
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Country | US
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Telephone | 800-378-5668
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Fax | 888-778-3902
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Provider Business Mailing Address
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Address Line | 1001 WILSHIRE BLVD # 2235
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City | LOS ANGELES
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State | CA
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Zip | 90017-2415
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Country | US
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Telephone | 800-378-5668
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Fax | 888-778-3902
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Authorized Official
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Title or Position | OWNER
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Name | LEROY SCOTT
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Credential | PMHNP
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Telephone | 800-377-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | 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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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