| Organization Name: | WELLNESS WILLOWS HOLISTIC HEALTH RETREAT INC |
| NPI Number: | 1790861086 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN LEE MURRAY-WACHTENDORF (DIRECTOR) |
| Mailing Address: | 16525 Mathis Rd Waller |
| State: | TX US |
| Postal Code: | 774844909 |
| Phone Number: | 9369313324 |
| Fax Number: | 8325537973 |
| NPI Enumeration Date: | 10/29/2006 |
| NPI Last Update Date: | 09/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0850X |
| License Number: | 63119 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Mental Health |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |