| Exceptional Wellness Of California Incorporated | |
|
626 Wilshire Blvd Ste 410 Los Angeles CA 90017-2915 | |
| (310) 750-4313 | |
| Not Available |
| Full Name | Exceptional Wellness Of California Incorporated |
|---|---|
| Speciality | Case Management |
| Location | 626 Wilshire Blvd Ste 410, Los Angeles, California |
| Authorized Official Name and Position | Shawnika Blate (ADMINISTRATOR) |
| Authorized Official Contact | 3107504313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exceptional Wellness Of California Incorporated 2440 Texas Pkwy Ste 335 Missouri City TX 77489-4098 Ph: () - | Exceptional Wellness Of California Incorporated 626 Wilshire Blvd Ste 410 Los Angeles CA 90017-2915 Ph: (310) 750-4313 |
| NPI Number | 1902421290 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 06/11/2020 |
| Certification Date | 06/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902421290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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