One Wellness Boutique, Inc.

LBN: One Wellness Boutique, Inc.
One Wellness Boutique, Inc. is an health care organization with primary practice located at 931 Monroe Dr Ne Ste A102-450 , Atlanta GA 30308-1793. The organization recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Agencies / Early Intervention Provider Agency, Ambulatory Health Care Facilities / Developmental Disabilities, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Multi-Specialty. Agencies / Community/Behavioral Health is the primary health care specialty. One Wellness Boutique, Inc. can be contacted via phone (404) 789-4079, or through Morris Jackson, Que'Ana Lache via phone (404) 789-4079.

Contact Information

Primary practice address
931 Monroe Dr Ne Ste A102-450 Atlanta GA 30308-1793
Phone: (404) 789-4079
Fax: (877) 833-3855
Website:
Map and Directions
Authorized official contact:
Name: Morris Jackson, Que'Ana Lache
Phone: (404) 789-4079

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / Early Intervention Provider Agency 252Y00000X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1669934030
LBN Legal business name One Wellness Boutique, Inc.
DBA Doing business as
Authorized official Morris Jackson, Que'Ana Lache
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 3rd, 2019
Last updated Apr 3rd, 2019 - about 5 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 1669934030 NPPES
Georgia MEDICAID 1972856805

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