| Butucha Wellness Llc | |
|
1362 Skipping Stone Ct Dacula GA 30019-4006 | |
| (617) 960-6852 | |
| (877) 760-0480 |
| Full Name | Butucha Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1362 Skipping Stone Ct, Dacula, Georgia |
| Authorized Official Name and Position | David Cuna (CEO AND PRESIDENT) |
| Authorized Official Contact | 6179606852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Butucha Wellness Llc 1362 Skipping Stone Ct Dacula GA 30019-4006 Ph: (617) 960-6852 | Butucha Wellness Llc 1362 Skipping Stone Ct Dacula GA 30019-4006 Ph: (617) 960-6852 |
| NPI Number | 1093402612 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Medicare PECOS PAC ID | 4789042813 |
|---|---|
| Medicare Enrollment ID | O20230622001749 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093402612 | NPI | - | NPPES |
| 14662512 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | David Cuna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487135539 PECOS PAC ID: 0941621049 Enrollment ID: I20201008002366 |
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