Provider Demographics
NPI:1730933417
Name:WELLNESS THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:WELLNESS THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALESHINLOYE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:951-532-3100
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-1325
Mailing Address - Country:US
Mailing Address - Phone:951-532-3100
Mailing Address - Fax:909-614-7644
Practice Address - Street 1:1255 W COLTON AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2861
Practice Address - Country:US
Practice Address - Phone:951-532-3100
Practice Address - Fax:909-614-7644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)