| Elemental Health Clinic Pllc | |
|
5030 Randall Pkwy Wilmington NC 28403-2829 | |
| (910) 240-4757 | |
| Not Available |
| Full Name | Elemental Health Clinic Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5030 Randall Pkwy, Wilmington, North Carolina |
| Authorized Official Name and Position | Havah Isabel Henzler (OWNER) |
| Authorized Official Contact | 9105994017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Health Clinic Pllc 5030 Randall Pkwy Wilmington NC 28403-2829 Ph: (910) 240-4757 | Elemental Health Clinic Pllc 5030 Randall Pkwy Wilmington NC 28403-2829 Ph: (910) 240-4757 |
| NPI Number | 1558015305 |
|---|---|
| Provider Enumeration Date | 02/10/2022 |
| Last Update Date | 02/10/2022 |
| Certification Date | 02/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558015305 | NPI | - | NPPES |
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