My Wellness Space LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MY WELLNESS SPACE LLC

Practice address

117 Coconut Key LN
Delray Beach, FL 33484-8832

Phone

(301) 752-6038

NPI assigned

May 3, 2021

Last updated

May 3, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Wadha Eid, COTA

Title

Owner

Phone

(301) 752-6038

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1447833884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 COCONUT KEY LN",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848832",
            "telephone_number": "301-752-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 COCONUT KEY LN",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848832",
            "telephone_number": "301-752-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY WELLNESS SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "EID",
        "authorized_official_first_name": "WADHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-752-6038",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.