Provider Demographics
NPI: | 1316830631 |
---|---|
Name: | AFYA WELLNESS CENTER INC |
Entity type: | Organization |
Organization Name: | AFYA WELLNESS CENTER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | MOHAMED |
Authorized Official - Middle Name: | MUMIN |
Authorized Official - Last Name: | OMAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 619-621-1908 |
Mailing Address - Street 1: | 924 48TH AVE NW |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCHESTER |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55901-6538 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 619-621-1908 |
Mailing Address - Fax: | 507-431-1095 |
Practice Address - Street 1: | 924 48TH AVE NW |
Practice Address - Street 2: | |
Practice Address - City: | ROCHESTER |
Practice Address - State: | MN |
Practice Address - Zip Code: | 55901-6538 |
Practice Address - Country: | US |
Practice Address - Phone: | 619-621-1908 |
Practice Address - Fax: | 507-431-1095 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-06-03 |
Last Update Date: | 2025-06-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 251E00000X | Agencies | Home Health |