THERAPEUTIC WELLNESS CENTER; NPI #1174858823

Contact Information

THERAPEUTIC WELLNESS CENTER

5974 FASHION POINT DR
SUITE 100
SOUTH OGDEN, UT 84403-4699

Phone: 801-479-9644
Fax: 801-479-9639
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for THERAPEUTIC WELLNESS CENTER

NPI Number 1174858823

LBN Legal business name THERAPEUTIC WELLNESS CENTER

Authorized official DAWN FIELDING - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/14/2009

Last updated 05/31/2012 - About 14 years ago

Identifiers

UT	License #	7487072-0161
UT	Other	U000072054	MEDICARE PTAN

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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