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Organization
EXCEPTIONAL WELLNESS OF CALIFORNIA INCORPORATED
Active
Organization
EXCEPTIONAL WELLNESS OF CALIFORNIA INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNIKA BLATE (ADMINISTRATOR)
(310) 750-4313
Entity
Organization
Contact information
Practice address
626 WILSHIRE BLVD STE 410, LOS ANGELES, CA 90017-2915
(310) 750-4313
Mailing address
2440 TEXAS PKWY STE 335, MISSOURI CITY, TX 77489-4098
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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