Fort Wellness, Pllc

LBN: Fort Wellness, Pllc
Fort Wellness, Pllc is an health care organization with primary practice located at 1809 Ridgmar Blvd , Fort Worth TX 76116-2018. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as the primary health care specialty. Fort Wellness, Pllc can be contacted via phone (682) 232-4003, or through Wallace, Rane Perry via phone (682) 232-4003.

Contact Information

Primary practice address
1809 Ridgmar Blvd Fort Worth TX 76116-2018
Phone: (682) 232-4003
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Rane Perry MS, LPC-INTERN, LCDC
Phone: (682) 232-4003

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1285181727
LBN Legal business name Fort Wellness, Pllc
DBA Doing business as
Authorized official Wallace, Rane Perry MS, LPC-INTERN, LCDC
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2016
Last updated Sep 1st, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285181727 NPPES
Texas Other 13854416 CAQH

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