Provider Demographics
NPI:1730557372
Name:APPLIED WELLNESS LLC
Entity type:Organization
Organization Name:APPLIED WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:207-242-5726
Mailing Address - Street 1:168 WALDOBORO RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:ME
Mailing Address - Zip Code:04348-3922
Mailing Address - Country:US
Mailing Address - Phone:207-242-5726
Mailing Address - Fax:207-512-1028
Practice Address - Street 1:168 WALDOBORO RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:ME
Practice Address - Zip Code:04348-3922
Practice Address - Country:US
Practice Address - Phone:207-242-5726
Practice Address - Fax:207-512-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP111091251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health