Wise Wellness Center LLC
Clinic/Center in Moorhead, MN. Organization (NPI-2).
NPI number1649033705
StatusActive
Last updated in NPPESFeb 1, 2024
Details
- NPI
- 1649033705
- Entity type
- Organization (NPI-2)
- Legal business name
- Wise Wellness Center LLC
- Organization subpart
- No
- Enumeration date
- Feb 1, 2024
- Certification date
- Feb 1, 2024
- Last updated
- Feb 1, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
1132 28th Ave S Ste 101aMoorhead, MN 56560-4420
Phone 612-443-9032
Mailing address
1132 28th Ave S Ste 101aMoorhead, MN 56560-4420
Authorized official
Cani Adan
Owner
6124439032
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