MEDICARE: WELLEX CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356667042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLEX CARE LLC

Provider Business Mailing Address
First Line	:	3150 LIVERNOIS RD STE 145
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-5000
Country	:	US
Telephone Number	:	248-619-2064
Fax Number	:	800-397-7124

Provider Business Practice Location Address
First Line	:	3150 LIVERNOIS RD STE 145
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-5000
Country	:	US
Telephone Number	:	248-619-2064
Fax Number	:	800-397-7124

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. SUJATHA SRIDHARAN
Credential	:
Telephone Number	:	248-760-6659

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	04/20/2010

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Directions to “WELLEX CARE LLC ” Practice Location

Language	Start Address	Practice Location

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