# WELLISTICS PHYSICAL THERAPY CENTER L3C

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

## Provider details

- **NPI number:** 1861848954
- **Authorized official:** MRS. GRISELDA ADAMS (OWNER)
- **Authorized official phone:** (504) 224-8400

## Contact information

- **Practice address:** 714 PHOSPHOR AVE, METAIRIE, LA 70005-2727
- **Practice address phone:** (504) 224-8400
- **Practice address fax:** (504) 272-0237
- **Mailing address:** 4228 WILLIAMS BLVD STE 201, KENNER, LA 70065-2270
- **Mailing address phone:** (504) 224-8400
- **Mailing address fax:** (504) 272-0237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 42124968G | LA | Yes |

## Other

- **Enumeration date:** 05/09/2016
- **Last updated:** 02/25/2022