Organization
AMBIENT WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMARI CHILDS (CHIEF EXECUTIVE OFFICER)
(415) 637-0232
Entity
Organization
Contact information
Practice address
2905 LAKETON RD, PITTSBURGH, PA 15235-4154
(415) 637-0232
Mailing address
2905 LAKETON RD, PITTSBURGH, PA 15235-4154
(415) 637-0232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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