| Eden Wellness Llc | |
|
22 Eury Ln Somerset KY 42501-4115 | |
| (859) 428-4374 | |
| Not Available |
| Full Name | Eden Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 22 Eury Ln, Somerset, Kentucky |
| Authorized Official Name and Position | Kelli N Jordan (OWNER) |
| Authorized Official Contact | 6065411067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Wellness Llc 162 Deluca Dr Science Hill KY 42553-9053 Ph: (606) 541-1067 | Eden Wellness Llc 22 Eury Ln Somerset KY 42501-4115 Ph: (859) 428-4374 |
| NPI Number | 1376361865 |
|---|---|
| Provider Enumeration Date | 10/02/2024 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Medicare PECOS PAC ID | 2264967470 |
|---|---|
| Medicare Enrollment ID | O20241125003937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376361865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelli N Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710380035 PECOS PAC ID: 7810268711 Enrollment ID: I20170811000708 |
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