| Blossom & Sprout Wellness, Pllc | |
|
3238 Gabriel Ave Zion IL 60099-3131 | |
| (224) 788-0188 | |
| Not Available |
| Full Name | Blossom & Sprout Wellness, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3238 Gabriel Ave, Zion, Illinois |
| Authorized Official Name and Position | Lafay Erving (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 2242378037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom & Sprout Wellness, Pllc 1713 Gilboa Ave Zion IL 60099-1618 Ph: (224) 788-0188 | Blossom & Sprout Wellness, Pllc 3238 Gabriel Ave Zion IL 60099-3131 Ph: (224) 788-0188 |
| NPI Number | 1932950953 |
|---|---|
| Provider Enumeration Date | 03/28/2024 |
| Last Update Date | 11/29/2024 |
| Certification Date | 11/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932950953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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