Organization
ULTIMATE WELLNESS PROVIDERS CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASONJA MALONE CCMA (CEO/OWNER)
(877) 768-4897
Entity
Organization
Contact information
Practice address
1880 S DAIRY ASHFORD RD STE 207-439, HOUSTON, TX 77077-4760
(877) 768-4897
Mailing address
1880 S DAIRY ASHFORD RD STE 207-439, HOUSTON, TX 77077-4760
(877) 768-4897
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
LA
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366970394
HOME HEALTH CARE SERVICES
LA
01
—
1366970394
HOME HEALTH CARE SERVICES
TX
05
—
1366970394
—
LA
05
—
1366970394
—
TX
Enumeration date
07/03/2017
Last updated
01/19/2025
Update your record
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