Provider Demographics
NPI:1861257453
Name:CHANNEL WELLNESS LLC
Entity type:Organization
Organization Name:CHANNEL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NARVILAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ESQ
Authorized Official - Phone:561-234-0326
Mailing Address - Street 1:1300 NW 17TH AVE STE 164&170
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2578
Mailing Address - Country:US
Mailing Address - Phone:561-234-0326
Mailing Address - Fax:
Practice Address - Street 1:1300 NW 17TH AVE STE 164&170
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2578
Practice Address - Country:US
Practice Address - Phone:561-234-0326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder