Organization
CELESTIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORTNIE WELLMAN (MANAGER/MEMBER)
(936) 582-1112
Entity
Organization
Contact information
Practice address
123 BLUE HERON DR, STE 201, MONTGOMERY, TX 77316-3192
(936) 582-1112
(936) 582-1151
Mailing address
123 BLUE HERON DR, STE 201, MONTGOMERY, TX 77316-3192
(936) 202-2849
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000226
TX
Other
Enumeration date
03/07/2014
Last updated
01/12/2017
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