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PRIME WELLNESS CENTER PLLC NPI 1548865678


NPI Information

NPI: 1548865678
Provider Name: PRIME WELLNESS CENTER PLLC

Doing Business As: REFLECTIONS LIFESTYLE CENTER

Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

CLIA Number: 45D2236780

Address:
4901 WINDHAVEN PKWY STE 200
THE COLONY, TX
ZIP 75056
Phone: (469) 777-4688
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PRIME WELLNESS CENTER PLLC is a substance abuse treatment and children substance abuse rehabilitation facility in The Colony, TX. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. PRIME WELLNESS CENTER PLLC NPI is 1548865678. The provider is registered as an organization entity type.
The provider Is Doing Business As Reflections Lifestyle Center.

The provider's business location address is:

4901 WINDHAVEN PKWY STE 200
THE COLONY, TX
ZIP 75056-828
Phone: (469) 777-4688
Fax: (469) 253-6167

The provider's authorized official is Efosa Airuehia .
The authorized official title is Physician/owner and has the following contact phone number (467) 777-4691.

The CLIA number assigned to this NPI record is 45D2236780 - other - php/iop with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/4/2020 and was last updated on 11/18/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
33245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14597-4667OTHERTEXASSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.