Provider Demographics
NPI:1730202953
Name:WELLNESS HOME CARE, INC.
Entity type:Organization
Organization Name:WELLNESS HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMOBOLAJI
Authorized Official - Middle Name:CELINA
Authorized Official - Last Name:LONGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MSN
Authorized Official - Phone:734-531-6431
Mailing Address - Street 1:3830 PACKARD ST STE 130-140
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2051
Mailing Address - Country:US
Mailing Address - Phone:734-531-6431
Mailing Address - Fax:734-531-6438
Practice Address - Street 1:3879 PACKARD ROAD
Practice Address - Street 2:UNIT B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108
Practice Address - Country:US
Practice Address - Phone:734-531-6431
Practice Address - Fax:734-531-6438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237716Medicare Oscar/Certification