Organization
MANIFEST WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BLOCK NP (CEO)
(716) 228-0590
Entity
Organization
Contact information
Practice address
375 LINWOOD AVE, BUFFALO, NY 14209-1663
(716) 228-0590
Mailing address
23 N AURORA ST, LANCASTER, NY 14086-2011
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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