| NPI | 1568200400 |
|---|---|
| Doing Business As | WELLNESS INTENSIVE OUTPATIENT PROGRAM PC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WELKE COO 747-998-0382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |