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NPI Code Detail

MEDICARE: ANANDA WELLNESS LLC

MEDICARE: ANANDA WELLNESS 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
1104100000XSocial Worker

General Provider Information

NPI Number : 1851981310
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANANDA WELLNESS LLC
Provider Business Mailing Address
First Line : PO BOX 10
Second Line :
City : MASON
State : MI
Zip : 48854-0010
Country : US
Telephone Number : 517-676-9788
Fax Number :
Provider Business Practice Location Address
First Line : 142 BRIGHTON LAKE RD
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-1738
Country : US
Telephone Number : 810-844-1476
Fax Number :
Authorized Official
Title or Position : CREDENTIALING
Name : MARYBETH HOUPT
Credential :
Telephone Number : 517-676-9788
Provider Enumeration Date : 01/19/2021
Last Update Date : 01/19/2021

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Directions to “ANANDA WELLNESS LLC ” Practice Location

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