Provider Demographics
NPI:1487477311
Name:ARIZA WELLNESS LLC
Entity type:Organization
Organization Name:ARIZA WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ASMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-713-9641
Mailing Address - Street 1:30 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1438
Mailing Address - Country:US
Mailing Address - Phone:860-713-9641
Mailing Address - Fax:
Practice Address - Street 1:30 WHEELER RD
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:MA
Practice Address - Zip Code:01740-1438
Practice Address - Country:US
Practice Address - Phone:860-713-9641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty