| Elemental Shift Llc | |
|
34 Forrester Street Salem MA 01970 | |
| (207) 671-4325 | |
| Not Available |
| Full Name | Elemental Shift Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 34 Forrester Street, Salem, Massachusetts |
| Authorized Official Name and Position | Kirsten Jettinghoff (OWNER) |
| Authorized Official Contact | 2076714325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Shift Llc 203 Washington St Ste 181 Salem MA 01970-3607 Ph: (207) 671-4325 | Elemental Shift Llc 34 Forrester Street Salem MA 01970 Ph: (207) 671-4325 |
| NPI Number | 1992418446 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992418446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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