Provider Demographics
NPI:1174144083
Name:UBUNTU BLACK FAMILY WELLNESS COLLECTIVE
Entity type:Organization
Organization Name:UBUNTU BLACK FAMILY WELLNESS COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LATANYA
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,CNM, FNP-C, RN
Authorized Official - Phone:615-830-7722
Mailing Address - Street 1:101 W NEWTOWN PL
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2975
Mailing Address - Country:US
Mailing Address - Phone:615-830-7722
Mailing Address - Fax:
Practice Address - Street 1:2611 GOVERNOR PRINTZ BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4518
Practice Address - Country:US
Practice Address - Phone:302-709-1838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health