| Anansi, Llc | |
|
201 W Franklin St Ste B Centerville OH 45459-4700 | |
| (937) 672-1424 | |
| Not Available |
| Full Name | Anansi, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 W Franklin St Ste B, Centerville, Ohio |
| Authorized Official Name and Position | Keith Vukasinovich (MANAGER) |
| Authorized Official Contact | 9376721424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anansi, Llc 201 W Franklin St Ste B Centerville OH 45459-4700 Ph: (937) 672-1424 | Anansi, Llc 201 W Franklin St Ste B Centerville OH 45459-4700 Ph: (937) 672-1424 |
| NPI Number | 1518654094 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Medicare PECOS PAC ID | 8921446741 |
|---|---|
| Medicare Enrollment ID | O20240329000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518654094 | NPI | - | NPPES |
| Provider Name | Keith Vukasinovich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982625208 PECOS PAC ID: 7214020221 Enrollment ID: I20240329000356 |
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