Provider Demographics
NPI:1871571778
Name:WELLNECESSITIES ,INC.
Entity type:Organization
Organization Name:WELLNECESSITIES ,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DESMARTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-222-0885
Mailing Address - Street 1:8835 LINE AVENUE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6718
Mailing Address - Country:US
Mailing Address - Phone:318-222-0885
Mailing Address - Fax:318-222-0883
Practice Address - Street 1:8835 LINE AVENUE
Practice Address - Street 2:SUITE 400
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-6718
Practice Address - Country:US
Practice Address - Phone:318-222-0885
Practice Address - Fax:318-222-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
8195362OtherCIGNA
B2923OtherBLUE CROSS BLUE SHIELD
5573004OtherAETNA
5573004OtherAETNA