Provider Demographics
NPI:1689498990
Name:WELLNESS CARE MANAGEMENT LLC
Entity type:Organization
Organization Name:WELLNESS CARE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDAOUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-666-1601
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-0058
Mailing Address - Country:US
Mailing Address - Phone:603-231-3904
Mailing Address - Fax:
Practice Address - Street 1:53 BACK RIVER RD
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-2665
Practice Address - Country:US
Practice Address - Phone:603-231-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities