Provider Demographics
NPI:1780606756
Name:WELLNESS HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:WELLNESS HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/VP/SEC./TREASURER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:561-575-6700
Mailing Address - Street 1:12142 175TH RD N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-4628
Mailing Address - Country:US
Mailing Address - Phone:561-575-6700
Mailing Address - Fax:561-744-7646
Practice Address - Street 1:12142 175TH RD N
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-4628
Practice Address - Country:US
Practice Address - Phone:561-575-6700
Practice Address - Fax:561-744-7646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0009641174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA0009641OtherMASSAGE LICENSE