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ONE WELLNESS BOUTIQUE INC. NPI 1669934030


NPI Information

NPI: 1669934030
Provider Name: ONE WELLNESS BOUTIQUE, INC.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
931 MONROE DR NE STE A102-450
ATLANTA, GA
ZIP 30308
Phone: (404) 789-4079
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ONE WELLNESS BOUTIQUE, INC. is a community behavioral health in Atlanta, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. ONE WELLNESS BOUTIQUE, INC. NPI is 1669934030. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

931 MONROE DR NE STE A102-450
ATLANTA, GA
ZIP 30308-793
Phone: (404) 789-4079
Fax: (877) 833-3855

The provider's authorized official is Que'ana Lache Morris Jackson .
The authorized official title is Owner and has the following contact phone number (404) 789-4079.

The enumeration date for this NPI number is 4/3/2019 and was last updated on 4/3/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2251C00000XDay Training, Developmentally Disabled ServicesNo
3261QD1600XClinic/CenterDevelopmental DisabilitiesNo
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
5261QM1300XClinic/CenterMulti-SpecialtyNo
6252Y00000XEarly Intervention Provider AgencyNo
7251S00000XCommunity/Behavioral HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11972856805MEDICAIDGEORGIA

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: 4/28/2024

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.