Organization
WELLBOUND OF MERCER LLC
Active
Parent organization
WELLBOUND LLC
Other names
WellBound of Mercer
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLBOUND LLC
Authorized official
SUSAN L DEL BENE (SECRETARY/CFO)
(650) 404-3618
Entity
Organization
Contact information
Practice address
3836 QUAKERBRIDGE RD, SUITE 208, HAMILTON, NJ 08619-1006
(609) 586-5001
(609) 586-1862
Mailing address
300 SANTANA ROW, SUITE 300, SAN JOSE, CA 95128-2423
(650) 404-3657
(650) 625-6007
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192821
—
NJ
01
—
24145
STATE OF NEW JERSEY
NJ
Enumeration date
01/08/2007
Last updated
12/29/2016
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