Organization Name: | STRATEGIC WELLNESS, LLC |
NPI Number: | 1942467154 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON SCOTT BLUEMLEIN (CEO) |
Mailing Address: | 2106 Chamber Center Dr Lakeside Park |
State: | KY US |
Postal Code: | 410171669 |
Phone Number: | 8594264673 |
Fax Number: | 8594265175 |
NPI Enumeration Date: | 05/16/2008 |
NPI Last Update Date: | 05/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0772 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |