Organization
NOURISH WELLNESS LLC
Active
Other names
Nourish Wellness LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TELITA OVIDE MSW (EXECUTIVE DIRECTOR/OWNER)
(504) 491-8963
Entity
Organization
Contact information
Practice address
820 LAKESHORE VILLAGE DR, SLIDELL, LA 70461-6605
(504) 491-8963
Mailing address
163 PARKHOUSE ST, DALLAS, TX 75207-7211
(504) 491-8963
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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