| Bend Mental Wellness Llc | |
|
19855 4th St Ste 106 Bend OR 97703-7814 | |
| (541) 357-7686 | |
| Not Available |
| Full Name | Bend Mental Wellness Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 19855 4th St Ste 106, Bend, Oregon |
| Authorized Official Name and Position | Edgar Julian Caballero (OWNER) |
| Authorized Official Contact | 5413577686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bend Mental Wellness Llc 64682 Cook Ave # 1 Bend OR 97703-9033 Ph: (541) 357-7686 | Bend Mental Wellness Llc 19855 4th St Ste 106 Bend OR 97703-7814 Ph: (541) 357-7686 |
| NPI Number | 1407446743 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 05/09/2023 |
| Certification Date | 05/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407446743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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