Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Health Service |
261QH0100X | |||
Rehabilitation |
261QR0400X | B4[14] | Rehabilitation Agency |
| NPI # | 1306207972 |
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| LBN Legal business name | WELL&LEAN LLC | ||||
| Authorized official | LESLIE DOMINGUEZ - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/10/2016 | ||||
| Last updated | 06/15/2016 - About 10 years ago | ||||
| Identifiers |
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