# WELLNESS REHAB CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548585623
- **Authorized official:** MISS QIAOLING LISA KUANG LMP (MEDICAL MASSAGE THERAPY)
- **Authorized official phone:** (917) 379-7532

## Contact information

- **Practice address:** 17227 128TH AVE, JAMAICA, NY 11434-3323
- **Practice address phone:** (718) 978-3389
- **Mailing address:** 17227 128TH AVE, JAMAICA, NY 11434-3323
- **Mailing address phone:** (718) 978-3389

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 04/01/2010
- **Last updated:** 04/01/2010