# AKASHA WELLNESS

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

## Provider details

- **NPI number:** 1881076859
- **Authorized official:** NICOLE LENCE MS, RDN, LDN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (618) 889-9570

## Contact information

- **Practice address:** 350 ZACH LN, OZARK, IL 62972-1119
- **Practice address phone:** (618) 889-9570
- **Mailing address:** 350 ZACH LN, OZARK, IL 62972-1119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 164.006153 | IL | Yes |

## Other

- **Enumeration date:** 06/25/2015
- **Last updated:** 06/25/2015