Provider Demographics
NPI:1154205896
Name:BETHESDA WELLNESS & RECOVERY LLC
Entity type:Organization
Organization Name:BETHESDA WELLNESS & RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONTE
Authorized Official - Middle Name:MANDELLA
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-590-2519
Mailing Address - Street 1:238 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-8074
Mailing Address - Country:US
Mailing Address - Phone:270-590-2519
Mailing Address - Fax:
Practice Address - Street 1:3745 ROSEVILLE RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-2269
Practice Address - Country:US
Practice Address - Phone:270-590-2519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty