Organization
WELLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMELLA CHARLENE JACKSON LPC (CEO)
(267) 307-9700
Entity
Organization
Contact information
Practice address
505 OLD YORK ROAD, SUITE 107, JENKINTOWN, PA 19046-1904
(267) 307-9700
(267) 307-9700
Mailing address
7973 THOURON AVE, PHILADELPHIA, PA 19150-2520
(267) 237-0042
(267) 907-1120
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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