# WELLSTREET HOME THERAPY & MEDICAL

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

## Provider details

- **NPI number:** 1881990414
- **Authorized official:** DR. JASON P MARINO PT (ADMINISTRATOR)
- **Authorized official phone:** (480) 836-2240

## Contact information

- **Practice address:** 16626 E AVENUE OF THE FOUNTAINS, STE. 102, FOUNTAIN HILLS, AZ 85268-8202
- **Practice address phone:** (480) 836-2240
- **Practice address fax:** (480) 836-2217
- **Mailing address:** 16626 E AVENUE OF THE FOUNTAINS, STE. 102, FOUNTAIN HILLS, AZ 85268-8202
- **Mailing address phone:** (480) 836-2240
- **Mailing address fax:** (480) 836-2217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/29/2011
- **Last updated:** 11/06/2012