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NPI Code Detail

MEDICARE: O&T HEALTH AND WELLNESS CENTER LLC

MEDICARE: O&T HEALTH AND WELLNESS CENTER 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1487517298
Entity Type Code : Organization
Provider Name (Legal Business Name) : O&T HEALTH AND WELLNESS CENTER LLC
Provider Business Mailing Address
First Line : 1204 E BASELINE RD STE 106
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1204 E BASELINE RD
Second Line : STE 106
City : TEMPE
State : AZ
Zip : 85283-1447
Country : US
Telephone Number : 480-915-5395
Fax Number :
Authorized Official
Title or Position : OWNER
Name : OLUWASEGUN VICTOR AFELUMO
Credential :
Telephone Number : 480-915-5395
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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